{"id":3105,"date":"2025-12-11T10:57:06","date_gmt":"2025-12-11T16:57:06","guid":{"rendered":"https:\/\/lacforglobalhealth.org\/reference-materials\/dialogue-outcomes\/"},"modified":"2025-12-12T15:00:36","modified_gmt":"2025-12-12T21:00:36","slug":"dialogue-outcomes","status":"publish","type":"page","link":"https:\/\/lacforglobalhealth.org\/en\/reference-materials\/dialogue-outcomes\/","title":{"rendered":"Dialogue Outcomes"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"3105\" class=\"elementor elementor-3105 elementor-3052\" wpc-filter-elementor-widget=\"1\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-563e7cd7 elementor-section-full_width elementor-section-height-min-height elementor-section-items-stretch elementor-section-content-middle elementor-reverse-tablet elementor-reverse-mobile elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"563e7cd7\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-622dcca1 exad-glass-effect-no exad-sticky-section-no\" data-id=\"622dcca1\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e3217f9 exad-sticky-section-no exad-glass-effect-no elementor-invisible elementor-widget elementor-widget-button\" data-id=\"e3217f9\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeIn&quot;,&quot;_animation_delay&quot;:&quot;200&quot;,&quot;_animation_mobile&quot;:&quot;none&quot;}\" data-widget_type=\"button.default\">\n\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/lacforglobalhealth.org\/en\/reference-materials\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">\u2190 Back to Reference Materials<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-24fe9c64 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-spacer\" data-id=\"24fe9c64\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4e3c9040 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"4e3c9040\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Dialogue Outcomes\nDocument<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4768f6f7 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"4768f6f7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">November 2025<\/p>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-75504f81 exad-glass-effect-no exad-sticky-section-no\" data-id=\"75504f81\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-597f0c45 elementor-widget-tablet__width-initial exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-image\" data-id=\"597f0c45\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"801\" src=\"https:\/\/lacforglobalhealth.org\/wp-content\/uploads\/2025\/10\/America-Latina-Caribe-e1761425969262.jpg\" class=\"attachment-large size-large wp-image-1711\" alt=\"Latin America and Caribe\" srcset=\"https:\/\/lacforglobalhealth.org\/wp-content\/uploads\/2025\/10\/America-Latina-Caribe-e1761425969262.jpg 942w, https:\/\/lacforglobalhealth.org\/wp-content\/uploads\/2025\/10\/America-Latina-Caribe-e1761425969262-300x300.jpg 300w, https:\/\/lacforglobalhealth.org\/wp-content\/uploads\/2025\/10\/America-Latina-Caribe-e1761425969262-150x150.jpg 150w, https:\/\/lacforglobalhealth.org\/wp-content\/uploads\/2025\/10\/America-Latina-Caribe-e1761425969262-768x769.jpg 768w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-798efa86 elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"798efa86\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3f0d3808 exad-glass-effect-no exad-sticky-section-no\" data-id=\"3f0d3808\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-288c3153 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-spacer\" data-id=\"288c3153\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-777119e9 elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"777119e9\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-669ebe16 exad-glass-effect-no exad-sticky-section-no\" data-id=\"669ebe16\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7215e8ca elementor-widget__width-initial elementor-toc--minimized-on-desktop exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-table-of-contents\" data-id=\"7215e8ca\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;headings_by_tags&quot;:[&quot;h2&quot;,&quot;h3&quot;],&quot;exclude_headings_by_selector&quot;:[],&quot;marker_view&quot;:&quot;bullets&quot;,&quot;icon&quot;:{&quot;value&quot;:&quot;&quot;,&quot;library&quot;:&quot;&quot;},&quot;no_headings_message&quot;:&quot;No se ha encontrado ning\\u00fan encabezado en esta p\\u00e1gina.&quot;,&quot;minimized_on&quot;:&quot;desktop&quot;,&quot;minimize_box&quot;:&quot;yes&quot;,&quot;hierarchical_view&quot;:&quot;yes&quot;,&quot;min_height&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_tablet&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_mobile&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]}}\" data-widget_type=\"table-of-contents.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-toc__header\">\n\t\t\t\t\t\t<h4 class=\"elementor-toc__header-title\">\n\t\t\t\tTable of Contents\t\t\t<\/h4>\n\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-toc__toggle-button elementor-toc__toggle-button--expand\" role=\"button\" tabindex=\"0\" aria-controls=\"elementor-toc__7215e8ca\" aria-expanded=\"true\" aria-label=\"Open table of contents\"><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-down\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M207.029 381.476L12.686 187.132c-9.373-9.373-9.373-24.569 0-33.941l22.667-22.667c9.357-9.357 24.522-9.375 33.901-.04L224 284.505l154.745-154.021c9.379-9.335 24.544-9.317 33.901.04l22.667 22.667c9.373 9.373 9.373 24.569 0 33.941L240.971 381.476c-9.373 9.372-24.569 9.372-33.942 0z\"><\/path><\/svg><\/div>\n\t\t\t\t<div class=\"elementor-toc__toggle-button elementor-toc__toggle-button--collapse\" role=\"button\" tabindex=\"0\" aria-controls=\"elementor-toc__7215e8ca\" aria-expanded=\"true\" aria-label=\"Close table of contents\"><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-up\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M240.971 130.524l194.343 194.343c9.373 9.373 9.373 24.569 0 33.941l-22.667 22.667c-9.357 9.357-24.522 9.375-33.901.04L224 227.495 69.255 381.516c-9.379 9.335-24.544 9.317-33.901-.04l-22.667-22.667c-9.373-9.373-9.373-24.569 0-33.941L207.03 130.525c9.372-9.373 24.568-9.373 33.941-.001z\"><\/path><\/svg><\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<div id=\"elementor-toc__7215e8ca\" class=\"elementor-toc__body\">\n\t\t\t<div class=\"elementor-toc__spinner-container\">\n\t\t\t\t<svg class=\"elementor-toc__spinner eicon-animation-spin e-font-icon-svg e-eicon-loading\" aria-hidden=\"true\" viewBox=\"0 0 1000 1000\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M500 975V858C696 858 858 696 858 500S696 142 500 142 142 304 142 500H25C25 237 238 25 500 25S975 237 975 500 763 975 500 975Z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-11be347f elementor-align-right elementor-widget__width-initial elementor-mobile-align-center exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-button\" data-id=\"11be347f\" data-element_type=\"widget\" data-e-type=\"widget\" download=\"\" data-widget_type=\"button.default\">\n\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/lacforglobalhealth.org\/wp-content\/uploads\/2025\/12\/LAC-Dialogue-Global-Health_Final-Report_4Dec-4.pdf\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-download\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M216 0h80c13.3 0 24 10.7 24 24v168h87.7c17.8 0 26.7 21.5 14.1 34.1L269.7 378.3c-7.5 7.5-19.8 7.5-27.3 0L90.1 226.1c-12.6-12.6-3.7-34.1 14.1-34.1H192V24c0-13.3 10.7-24 24-24zm296 376v112c0 13.3-10.7 24-24 24H24c-13.3 0-24-10.7-24-24V376c0-13.3 10.7-24 24-24h146.7l49 49c20.1 20.1 52.5 20.1 72.6 0l49-49H488c13.3 0 24 10.7 24 24zm-124 88c0-11-9-20-20-20s-20 9-20 20 9 20 20 20 20-9 20-20zm64 0c0-11-9-20-20-20s-20 9-20 20 9 20 20 20 20-9 20-20z\"><\/path><\/svg>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Download PDF<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-68f6fc1d elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"68f6fc1d\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3a576005 exad-glass-effect-no exad-sticky-section-no\" data-id=\"3a576005\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-727bf2b6 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"727bf2b6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Foreword<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-4a264153 elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"4a264153\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-4e1028ce exad-glass-effect-no exad-sticky-section-no\" data-id=\"4e1028ce\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-eb4555 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"eb4555\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Working in global health over the past 40 years, I have come to see that the task of discussing how to reform the global health system is profoundly challenging. To start, we need to recognize that \u201cthe system\u201d exists only as a metaphor. It is not a concrete system like the system that runs my watch or the system that runs my old car; these things can be physically touched and concretely defined. The global health system, by contrast, is more intangible and ambiguous. Its boundaries and borders are poorly defined and hotly contested. Who decides what is inside the system and what is outside? Who assigns roles among the actors or elements of the system? Yet, even without clear boundaries, there is broad agreement that the global health system is changing.       <\/p><p>Many people talk about the \u201carchitecture\u201d of the global health system. But we need to recognize that there is no \u201carchitect\u201d systematically designing and thinking about how to redesign it. We have a global health community made up of neighborhoods where each owner decides the structure, the land, and the design of its buildings, in competition with neighbors, depending on their relative power. Global health is a patchwork quilt with gaps and overlaps, with each piece created through crises and opportunities at critical historical moments. The result today is a quasi-system that has achieved successes but would benefit from a critical review to achieve better performance in the 21st century. In my view, the goal of this dialogue is not consensus but rather the search for good and innovative ideas.     <\/p><p>Tractable changes that hold the potential for making positive differences. This may require disruption of the existing order; it may require confronting uncomfortable patterns. But I am confident that this exercise is worth doing, if it can provoke thoughtful action. In the pages that follow, look for inspiration and guidance on rethinking the challenges that the global health community confronts today, with hints from Latin America and the Caribbean. I hope that the document will contribute to this needed rethinking, so that we can be more effective in achieving the ethical principles of global health for a better world.    <\/p><p><strong>Michael R. Reich<\/strong><\/p><p>Taro Takemi <strong>Professor Emeritus<\/strong> of International Health Policy at the Harvard T.H. Chan School of Public Health<\/p><p><em>Chair of the LAC-Dialogue Convening<\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-267c2bfd elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"267c2bfd\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4eaa1387 exad-glass-effect-no exad-sticky-section-no\" data-id=\"4eaa1387\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-25fa5bd7 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"25fa5bd7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Abbreviations<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5cbad921 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-shortcode\" data-id=\"5cbad921\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\">\n<table id=\"tablepress-7\" class=\"tablepress tablepress-id-7\">\n<tbody class=\"row-hover\">\n<tr class=\"row-1\">\n\t<td class=\"column-1\">BCIE <\/td><td class=\"column-2\">Central American Bank for Economic Integration<\/td>\n<\/tr>\n<tr class=\"row-2\">\n\t<td class=\"column-1\">CAF <\/td><td class=\"column-2\">Development Bank of Latin America and the Caribbean<\/td>\n<\/tr>\n<tr class=\"row-3\">\n\t<td class=\"column-1\">CARICOM <\/td><td class=\"column-2\">Caribbean Community<\/td>\n<\/tr>\n<tr class=\"row-4\">\n\t<td class=\"column-1\">CDC <\/td><td class=\"column-2\">Center for Disease Control<\/td>\n<\/tr>\n<tr class=\"row-5\">\n\t<td class=\"column-1\">CELAC <\/td><td class=\"column-2\">Community of Latin American and Caribbean States<\/td>\n<\/tr>\n<tr class=\"row-6\">\n\t<td class=\"column-1\">COP30 <\/td><td class=\"column-2\">World Climate Summit (2025 United Nations Climate Change Conference)<\/td>\n<\/tr>\n<tr class=\"row-7\">\n\t<td class=\"column-1\">D4D <\/td><td class=\"column-2\">debt for development<\/td>\n<\/tr>\n<tr class=\"row-8\">\n\t<td class=\"column-1\">HTA <\/td><td class=\"column-2\">health technology assessment<\/td>\n<\/tr>\n<tr class=\"row-9\">\n\t<td class=\"column-1\">IDB <\/td><td class=\"column-2\">Inter-American Development Bank<\/td>\n<\/tr>\n<tr class=\"row-10\">\n\t<td class=\"column-1\">IECS <\/td><td class=\"column-2\">Institute for Clinical Effectiveness and Health Policy<\/td>\n<\/tr>\n<tr class=\"row-11\">\n\t<td class=\"column-1\">LAC <\/td><td class=\"column-2\">Latin America and the Caribbean<\/td>\n<\/tr>\n<tr class=\"row-12\">\n\t<td class=\"column-1\">LAC-HCP <\/td><td class=\"column-2\">LAC Health Catalytic Platform<\/td>\n<\/tr>\n<tr class=\"row-13\">\n\t<td class=\"column-1\">M&amp;E <\/td><td class=\"column-2\">monitoring and evaluation<\/td>\n<\/tr>\n<tr class=\"row-14\">\n\t<td class=\"column-1\">ORAS-CONHU<\/td><td class=\"column-2\">Andean Health Organization \u2013 Hip\u00f3lito Unanue Agreement<\/td>\n<\/tr>\n<tr class=\"row-15\">\n\t<td class=\"column-1\">PAHO <\/td><td class=\"column-2\">Pan American Health Organization<\/td>\n<\/tr>\n<tr class=\"row-16\">\n\t<td class=\"column-1\">PHC <\/td><td class=\"column-2\">primary health care<\/td>\n<\/tr>\n<tr class=\"row-17\">\n\t<td class=\"column-1\">RPG <\/td><td class=\"column-2\">regional public goods<\/td>\n<\/tr>\n<tr class=\"row-18\">\n\t<td class=\"column-1\">SICA <\/td><td class=\"column-2\">Central American Integration System<\/td>\n<\/tr>\n<tr class=\"row-19\">\n\t<td class=\"column-1\">SIDS <\/td><td class=\"column-2\">Small Island Developing States<\/td>\n<\/tr>\n<tr class=\"row-20\">\n\t<td class=\"column-1\">UHC <\/td><td class=\"column-2\">universal health coverage<\/td>\n<\/tr>\n<tr class=\"row-21\">\n\t<td class=\"column-1\">UWI <\/td><td class=\"column-2\">University of the West Indies<\/td>\n<\/tr>\n<tr class=\"row-22\">\n\t<td class=\"column-1\">WHO <\/td><td class=\"column-2\">World Health Organization<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<!-- #tablepress-7 from cache --><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-52039648 elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"52039648\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2dbbf2eb exad-glass-effect-no exad-sticky-section-no\" data-id=\"2dbbf2eb\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1bd1b6e exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"1bd1b6e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Executive Summary<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7c4f035c exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"7c4f035c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">This document synthesizes a regional dialogue that engaged stakeholders from the 33 countries of Latin America and the Caribbean (LAC) to reimagine the global health architecture. The consultation\u2014comprising 75 in-depth interviews, an open survey, three subregional webinars, and a high-level convening in Mexico City gathering 44 regional actors\u2014reflects diverse voices from government, academia, civil society, regional institutions, the private sector, and multilateral organizations. <\/p><p class=\"p1\"><strong>Where we are now:<\/strong> LAC occupies an ambiguous position within the current global health architecture\u2014 \u201dneither poor enough to receive substantial cooperation, nor rich enough to sit at the decision-making table.\u201d The region experiences a system designed by and for the Global North, with financing and priorities focused on vertical programs that do not align with LAC\u2019s predominant challenges: noncommunicable diseases, mental health, climate vulnerability, and health system strengthening. Large multilateral bodies are perceived as bureaucratic and insufficiently responsive, while fragmented coordination creates duplication and administrative overload. However, critical regional assets exist: the Pan American Health Organization Revolving Funds demonstrate proven market-shaping capacity, technical cooperation remains strong, and there is significant untapped potential for South-South collaboration and regional public goods production.<\/p><p class=\"p1\"><strong>Reimagining the future architecture:<\/strong> Reform must be regionally grounded and globally connected. The proposed architecture involves refocusing global mandates on stewardship, norm-setting, and emergency coordination, while devolving technical cooperation to strengthened regional mechanisms. Governance must become more inclusive, transparent, and binding. Three interconnected platforms would operationalize this vision: (1) a LAC Innovation Hub to systematize peer-to-peer technical exchange; (2) a LAC Health Catalytic Platform to coordinate investment in regional public goods and enable joint procurement and manufacturing; and (3) a Regional Solidarity Fund to pool catalytic financing from multilateral banks, innovative taxation, and domestic resources.   <\/p><p class=\"p1\"><strong>How to enable this new architecture:<\/strong> Implementation requires securing high-level political and financial leadership. LAC heads of government, ministers of finance, and regional champions must drive the agenda through regional summits and global forums. This political platform must be anchored in binding agreements sustained beyond electoral cycles. In parallel, the region should modernize existing mechanisms, establish innovative domestic revenue sources, and integrate health into broader economic, climate, and trade strategies through \u201cHealth in All Policies\u201d frameworks engaging the non-health ministries that control necessary political and financial levers.   <\/p><p class=\"p1\">LAC brings a tradition of solidarity, proven pooled procurement models, and deep experience managing diverse contexts. By strengthening regional self-sufficiency and amplifying LAC\u2019s voice globally, this reform agenda can transform the region\u2019s health future while contributing to a more equitable and responsive global health architecture for all. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-22669c1d elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"22669c1d\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3d2cd8a8 exad-glass-effect-no exad-sticky-section-no\" data-id=\"3d2cd8a8\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-10566013 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"10566013\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Purpose of the Document<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-60e6d93e exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"60e6d93e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">This dialogue outcomes document synthesizes the perspectives, priorities, and reform proposals collected through an inclusive consultation process that engaged more than one hundred actors across all countries of the LAC region between August and November 2025. It reflects the insights of government representatives, regional institutions, academia, civil society, the private sector, and technical experts, ensuring a diverse and regionally grounded assessment of how the global health architecture can be transformed. The document does not claim to represent a unified regional position but rather captures the breadth of experiences and ideas that emerged through this wide-ranging dialogue.  <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1ed5f960 elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"1ed5f960\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2b855741 exad-glass-effect-no exad-sticky-section-no\" data-id=\"2b855741\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3ffe70fa exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"3ffe70fa\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Background<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1fa767aa exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"1fa767aa\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">The LAC Dialogue on Reforming the Global Health Architecture\u2014alongside four parallel dialogues in Asia and the Pacific, Africa, Europe and North America, and the Middle East and Central Asia\u2014is part of a Wellcome Trust initiative to leverage collective thinking and surface emerging areas of consensus on global health reform priorities, drawing on ideas set out in initial proposals commissioned from innovative thought leaders and on those that emerge through the dialogues. The dialogue in the LAC region was led by an academic consortium formed by Tecnol\u00f3gico de Monterrey (Mexico), Universidad Mayor (Chile), the Institute for Clinical and Health Effectiveness (IECS, Argentina), and the University of the West Indies (UWI, Jamaica). Teams from all four institutions brought together different areas of expertise to form a shared view and better understand stakeholders\u2019 perspectives on the current global health architecture.  <\/p><p class=\"p1\">A central point of debate concerned the region\u2019s place and role in global health. Participants reflected that LAC has shaped major global health agendas in recent decades\u2014championing universal health coverage (UHC), advancing primary health care (PHC), and pushing back against harmful commercial determinants of health. However, the LAC region\u2019s participation in the global health architecture has largely been marginal, resulting in minimal influence over priorities, financing decisions, and the design of global mechanisms. Furthermore, the LAC region is often treated as a unified region, yet it is characterized by significant cultural, geographic, demographic, and socioeconomic diversity that produces equally diverse health needs and system capacities. For instance, subregions such as the Caribbean and South America differ markedly in scale, resources, and institutional structures; countries range from small island states with acute climate and structural vulnerabilities to large middle-income economies facing fiscal pressures, political instability, and fragmented health systems. Although most LAC countries are classified as middle- or upper-middle- income, persistent inequalities, high out-of-pocket expenditures, and widespread unmet health needs mean that millions of people continue to live in poverty with unmet health needs.     <\/p><p class=\"p1\">This dialogue represented a unique opportunity to debate, contrast, and build reform proposals from the region\u2019s diversity, identifying points of convergence that can form a joint voice in the global debate that will take place in 2026.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-af40bcd elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"af40bcd\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-329e078 exad-glass-effect-no exad-sticky-section-no\" data-id=\"329e078\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-f3b98da exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"f3b98da\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">Box 1. <strong>Methodology<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5a6e654 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"5a6e654\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">Stage 1: Regional consultation:<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3ae1b48 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"3ae1b48\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<ul><li class=\"p1\">One-on-one interviews with 75 key actors: Interviewees were identified through comprehensive stakeholder mapping supported by AI-assisted web scraping to ensure balance across sectors. Interviews centered on three questions: (1) Where are we now? (2) What should be the function and form of the future global health architecture? (3) How can this new global health architecture be enabled?   <\/li><li class=\"p1\">A public online survey consisted of a series of questions aimed at capturing views on global health system priorities, challenges, and opportunities for reform. The survey collected more than 40 responses. <\/li><li class=\"p1\">Three subregional webinars with more than 100 participants overall where preliminary findings from the interviews were shared and discussed.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-4ca3330 exad-glass-effect-no exad-sticky-section-no\" data-id=\"4ca3330\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-ec9cb88 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"ec9cb88\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">We implemented a two-stage, time-bound, multi-stakeholder consultation that included the perspective of 75 interviewees and 44 participants in the convening from the 33 countries of the region and engaged different sectors, such as government, academia, private-sector organizations, multilateral agencies, and civil society groups across most of the countries in the region.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e219ade exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"e219ade\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">Stage 2: Regional convening:<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9ae2ca8 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"9ae2ca8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">An in-person meeting in Mexico City (12\u201313 November) brought together 44 regional stakeholders to examine five priority themes: (1) Keeping and strengthening what works; (2) Ensuring sustainable financing; (3) Reforming major global health institutions and exploring innovative governance arrangements; (4) Redesigning the global health architecture to achieve health equity; and (5) Strengthening technical cooperation and coordination among countries.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-4ad018f elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"4ad018f\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-a04debd exad-glass-effect-no exad-sticky-section-no\" data-id=\"a04debd\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-228a434 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-spacer\" data-id=\"228a434\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-478b7f1f elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"478b7f1f\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7ee828e5 exad-glass-effect-no exad-sticky-section-no\" data-id=\"7ee828e5\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-44c4dcfe exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"44c4dcfe\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Taking Stock<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7b32bc63 elementor-widget__width-initial exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"7b32bc63\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Key challenges of the current global health system<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-608b3be elementor-widget__width-initial exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"608b3be\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">The region\u2019s needs are not reflected in the current top-down system<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-69012a00 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"69012a00\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<ul><li class=\"p1\">There is a shared sense in LAC of being at the margins of a global health system that remains largely conceived, governed, and financed from the Global North, as well as limited due to criteria used for assignment of resources: \u201cneither poor enough to receive large flows of cooperation, nor rich enough to finance its own solutions [\u2026] We are neither recipients nor donors [\u2026] we are taken out of the game.\u201d This results in the loss of non-reimbursable aid and favorable financial conditions. <\/li><li class=\"p1\"><span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, 'Helvetica Neue', Arial, 'Noto Sans', sans-serif, 'Apple Color Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol', 'Noto Color Emoji';\">Global cooperation and financing continue to prioritize other regions and vertical issues such as malaria and HIV.<\/span> While these approaches have yielded important gains for vulnerable populations, they also narrow the scope of support, diverting attention from the region\u2019s predominant health challenges\u2014 noncommunicable diseases, primary care, mental health, and the broader need for comprehensive health-system strengthening. <\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b7e5e1a elementor-widget__width-initial exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"b7e5e1a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">A complex and fragmented architecture deters effective technical collaboration<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-28c5a90 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"28c5a90\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<ul><li class=\"p1\"><p class=\"p1\">Large multilateral bodies are perceived as bureaucratic, slow to adapt, and structured in ways that limit technical responsiveness and innovation, often resulting in collaboration that remains largely administrative rather than leading to concrete actions: \u201cNinety percent of what we do is PowerPoint. Very little reaches the field, very few real solutions.\u201d<\/p><\/li><li class=\"p1\"><p class=\"p1\">The current architecture does not promote synergies among global, regional, and national levels. Instead of complementing existing capacities, many international actors operate in parallel, creating duplication and displacing functions that could be more effectively carried out by local or regional institutions. Moreover, relying on external actors often results in tools and analyses that are not tailored to local needs: \u201cWe need to start by mapping the capabilities we have in each country and what each can offer. And part of the process is helping countries improve their capabilities.\u201d  <\/p><\/li><li class=\"p1\"><p class=\"p1\">Deep fragmentation and a crowded field of actors with diverse and duplicate agendas undercut cross-learning and cross-fertilization. Aspects include short-term funding cycles, weak and outdated coordination mechanisms, and entrenched power asymmetries that constrain country ownership, sufficiency, and strategic coherence\u2014while overloading the administrative capacity of the recipient countries: \u201cCoordination is deficient, and organizations compete against each other\u201d; \u201c&#8230;everything is a priority, and we\u2019re all pulling in all directions.\u201d <\/p><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-36abb9e elementor-widget__width-initial exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"36abb9e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Regional heterogeneity and contexts require consideration<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8c513a5 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"8c513a5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<ul><li class=\"p1\"><p class=\"p1\"><strong>Overlooked vulnerabilities: <\/strong>Small Island Developing States (SIDS) are classified as \u201chigh-income\u201d despite having to invest significant resources annually to recover from climate emergencies and natural disasters.<\/p><\/li><li class=\"p1\"><p class=\"p1\"><strong>Nonexistent South-South financing:<\/strong> A major challenge lies in financing international and South-South cooperation, as no sustainable mechanisms currently exist for regional cooperation.<\/p><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5c1bd4f1 elementor-widget__width-initial exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"5c1bd4f1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Keeping and strengthening what works<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-35e4097e exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"35e4097e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Participants expressed optimism about working together regionally despite acknowledging <em>\u201clanguage <\/em><em>barriers and lack of a strong regional identity.\u201d<\/em> This optimism rests on recognition of shared challenges\u2014 inequality, fragmented systems, exclusion from global decision-making, and climate vulnerability\u2014that transcend subregional differences. As one participant noted, <em>\u201cThere was a feeling of common identity as a <\/em><em>region&#8230; regardless of diversity and differences among subregions.\u201d<\/em> <\/p><p><strong>Production of global public goods: <\/strong>The Pan American Health Organization (PAHO), the World Health Organization (WHO), and multilateral development banks generate technical standards, regulatory guidance, scientific evidence, and reports and statistics that countries rely on for decision-making. There is strong interest across the region in strengthening its ability to produce its own regional public goods, ranging from knowledge generation to surveillance and monitoring. Expanding regional capabilities would make the system more responsive and grounded in real conditions.   <\/p><p><strong>Proven market-shaping capacity:<\/strong> PAHO\u2019s Revolving Funds have demonstrated the region\u2019s ability to shape health markets\u2014pooling demand to secure lower prices, ensure reliable supply, and expand access to vaccines and essential medicines. Although these funds are a major regional asset, there is Latin America and the Caribbean Dialogue on Reforming the Global Health Architecture 9 broad agreement that these structures require modernization, adaptation, and expansion to aggregate demand more effectively across regions and unlock the region\u2019s full negotiation potential. Moreover, there are missed opportunities for pooled supply of regional public goods: fragmentation prevents collective investments (regional vaccine production, joint R&amp;D, a regional Center for Disease Control [CDC]) that would strengthen supply security and regional autonomy.  <\/p><p><strong>Technical cooperation:<\/strong> This remains a strong pillar of the current global health architecture; however, it could be reconfigured so that this function is increasingly carried out by national institutions, rather than primarily by technical staff in global or regional bodies such as WHO or PAHO.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3690e028 elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"3690e028\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7140f1f8 exad-glass-effect-no exad-sticky-section-no\" data-id=\"7140f1f8\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3e387521 elementor-widget__width-initial elementor-widget-mobile__width-initial exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"3e387521\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Reimagining the Architecture:\nFunctions and Forms<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4d697498 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"4d697498\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">Much of the discussion about functions and forms of a reimagined architecture gravitated toward what can realistically be achieved at the regional level\u2014an emphasis that likely reflects the region\u2019s current position within the global health architecture. Participants noted that regional bodies are the mechanisms they know best and interact with most frequently, whereas global institutions often feel distant, slow, or insufficiently attuned to local priorities. <\/p><p class=\"p1\">This orientation is also linked to the region\u2019s self-perception that it possesses sufficient capacity to solve its own challenges and to support countries both within and beyond LAC. Participants argued that the region has ample internal expertise and practical experience to drive meaningful improvements, particularly if mechanisms for systematic peer learning and exchange are strengthened. <\/p><p class=\"p1\">For many countries, especially those not reliant on substantial external financing, the day-to-day experience of governance, coordination, and technical support is mediated far more by regional entities than by global ones. This practical reality shaped the dialogue: proposals for reform tended to focus on enhancing regional capacities and cooperation, even as participants acknowledged the continued need for effective global engagement. However, viewed from another angle, several regional strengths and initiatives could serve as models that may be adopted or scaled up at the global level. There were four key proposed changes to reconfigure the functions and forms of a new architecture.   <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4fd8e65 elementor-widget__width-initial exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"4fd8e65\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">1. Refocus Global Mandates<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-76074f2 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"76074f2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<ul><li class=\"p1\"><p class=\"p1\">WHO and PAHO should focus primarily on core, centralized functions such as stewardship, norm-setting, policy guidelines, international advocacy, and coordinating emergency response. This shift would devolve technical cooperation and capacity-building functions to the regional level, where they can be handled more appropriately. <\/p><\/li><li class=\"p1\"><p class=\"p1\">Another idea proposed was refocusing the mandate of multilateral development banks toward long-term health system strengthening, including consolidating global financing streams so that a single multilateral bank\u2014rather than multiple parallel institutions\u2014provides coordinated support for this function.<\/p><\/li><li><p class=\"p1\">The regional level should concentrate on leveraging economies of scale and strengthening regional public goods through joint procurement mechanisms; coordinated production of health commodities and services; regulatory harmonization; South-South cooperation; and emergency response capacity. Participants emphasized that such regional agreements must be binding and sustained, not merely declarative. <\/p><\/li><li><p class=\"p1\">At the national level, governments must lead domestic health financing efforts, working to reduce inequalities and ensure universal access while strengthening state stewardship and accountability to citizens. Participants agreed that although fiscal margins are limited, domestic investment in health\u2014 including concessional loans from development banks\u2014is essential; external cooperation can only play a complementary role. <\/p><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-4f3c4b1 elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"4f3c4b1\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-47968e9 exad-glass-effect-no exad-sticky-section-no\" data-id=\"47968e9\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-ae5076f exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"ae5076f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">Box 2. <strong>PAHO at a Crossroads: Key Regional Tensions<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-e045f1c elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"e045f1c\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-366107d exad-glass-effect-no exad-sticky-section-no\" data-id=\"366107d\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-a0c2dd6 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"a0c2dd6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">One constant emerged in the dialogue: sustained reflection on PAHO\u2019s role and whether its mission and functions should be redefined for the future or maintained as they are.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-84ee863 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"84ee863\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\"><em>Areas of Broad Agreement<\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-186c886 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"186c886\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\"><strong>1. Modernization and Reduced Bureaucracy:<\/strong><\/p><p class=\"p1\">Stakeholders agreed that PAHO must break with the status quo and modernize its structures, reduce cumbersome processes, and strengthen sustained in-country capacity rather than rely on short-term external consultants.<\/p><p class=\"p1\"><strong>2. Decentralization and Proximity to Countries: <\/strong><\/p><p class=\"p1\">There was strong agreement on the need for PAHO staff\u2014initially trained in countries\u2014and headquarters office to return to the region, ensuring greater responsiveness and alignment with local realities.<\/p><p class=\"p1\"><strong>3. More Inclusive Governance and Advocacy:<\/strong><\/p><p class=\"p1\">Dialogue participants support increased participation of civil society and academia in governance and advisory functions to enhance legitimacy, accountability, and advocacy.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-0bb6c12 exad-glass-effect-no exad-sticky-section-no\" data-id=\"0bb6c12\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-a201781 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"a201781\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\"><em>Areas of Disagreement<\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2941285 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"2941285\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\"><strong>1. Divergent Regional Experiences: <\/strong><\/p><p class=\"p1\">Caribbean countries report highly positive engagement with PAHO, while Latin American countries\u2014especially larger ones\u2014perceive PAHO as distant and overly uniform (\u201cpainting the region with the same brush\u201d). This divide stems largely from PAHO\u2019s operational model in the Caribbean, which is different from the strategy in other countries, where each island has a dedicated coordinator, often embedded in the Ministry of Health. This \u201cdeep-connection philosophy\u201d generates trust, rapid responsiveness, and strong perceived value.  <\/p><p class=\"p1\"><strong>2. Uneven Power and Participation: <\/strong><\/p><p class=\"p1\">The Caribbean values PAHO\u2019s advocacy in global forums, where small states struggle to be heard, but at the same time participate less in formal governance (e.g., PAHO\u2019s Directing Council). This contradiction raises concerns about the small states influence over PAHO\u2019s strategic decisions. <\/p><p class=\"p1\"><strong>3. Reform Sensitivities and Dependency: <\/strong><\/p><p class=\"p1\">The idea of reform may be interpreted by some in the Caribbean as a threat to the one-country-one-vote system where the subregion holds more weight than LAC. Some countries\u2014particularly small islands\u2014fear losing current benefits through reform. A broader paradox also persists: Member States have the authority to demand reform but depend on PAHO\u2019s support, weakening incentives for change. This issue remains unresolved.   <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-71aec13 elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"71aec13\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-136f88d exad-glass-effect-no exad-sticky-section-no\" data-id=\"136f88d\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1b70ab2 elementor-widget__width-initial exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"1b70ab2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">2. Decentralize Governance<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-af70082 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"af70082\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">A major thrust of the reform movement is redirecting decision-making power away from centralized global institutions toward regional and national mechanisms, recognizing that public health requires local capacity and leadership. To this end: <\/p><ul><li class=\"p1\">Global structures should support regional leadership without overshadowing local capacity. Additionally, to enhance countries\u2019 representation in the global debate, boards of all global health initiatives should include representatives of the countries served (some institutions already do this). The region as a whole should also reactivate or generate new spaces for more meaningful participation in the global debate.  <\/li><li class=\"p1\"><span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, 'Helvetica Neue', Arial, 'Noto Sans', sans-serif, 'Apple Color Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol', 'Noto Color Emoji';\">Large multilateral institutions must right-size and become more agile, act as catalysts for innovation, <\/span>and provide national actors with greater influence in shaping regional and global health agenda. This also implies a more inclusive and transparent governance model: representation in the governing bodies of multilateral institutions should extend beyond governments to systematically include civil society, academia, users, and patient groups in monitoring, policy development, and decision-making. Transparency in financing, staffing, and performance should be significantly strengthened to build public trust and ensure that institutions remain accountable to countries and citizens.  <\/li><li class=\"p1\">Academia should play a central role in generating evidence and providing independent analysis, while civil society, communities, and patient organizations must be involved in monitoring progress and contributing to policy development. One way to move forward is for academia to join efforts for specific projects (such as the one carried out by the consortium of universities on this project); a more sustainable approach in the long run would be for a set of institutions, grouped under the LAC Innovation Hub (see below) to lead joint efforts. <\/li><li class=\"p1\">To avoid repeating the shortcomings of the current architecture, the reformed system must be governed by binding rules with clear consequences for non-compliance (or alternatively, a well-designed incentive system), rather than informal arrangements based on personal relationships or goodwill.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-859beae elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"859beae\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-f448b16 exad-glass-effect-no exad-sticky-section-no\" data-id=\"f448b16\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-878323e exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"878323e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">Box 3. <strong>Improving LAC\u2019s Position within the Current Architecture<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-f5b6f9c elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"f5b6f9c\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-311619f exad-glass-effect-no exad-sticky-section-no\" data-id=\"311619f\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-8fe4d08 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"8fe4d08\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<ul><li class=\"p1\"><strong>Strengthen regional identity and solidarity by fostering shared narratives<\/strong> that reflect Latin America and the Caribbean\u2019s diverse but interconnected realities.<\/li><li class=\"p1\"><strong>Develop common regional agendas:<\/strong> LAC must unify and coordinate its political position to present a strong force globally, recognizing that health diplomacy requires inserting health concerns into the broader agendas of high-level forums like the G20.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-557b763 exad-glass-effect-no exad-sticky-section-no\" data-id=\"557b763\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5f0628d exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"5f0628d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<ul><li class=\"p1\"><strong>Institutionalize cross-subregional coordination through regular, structured platforms<\/strong> linking the Caribbean Community (CARICOM), the Central American Integration System (El Sistema de la Integraci\u00f3n Centroamericana, or SICA), the Andean Community, Mercosur, and other regional mechanisms.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-a561fcb elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"a561fcb\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-586a6e7 exad-glass-effect-no exad-sticky-section-no\" data-id=\"586a6e7\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-165d9fd elementor-widget__width-initial exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"165d9fd\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">3. Rebuild Global Health from the Regional Level<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-983e87a exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"983e87a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">Strengthening the global health architecture increasingly depends on what happens at the regional level. Regions are where political priorities converge, where coordination is most immediate, and where institutions have the contextual knowledge to provide timely support. In LAC, participants emphasized that meaningful global reform must build on strong regional cooperation\u2014both to address shared challenges and to amplify the region\u2019s voice in global decision-making. By reinforcing regional mechanisms and leveraging local expertise, countries can contribute to a more coherent, responsive, and equitable global health system.   <\/p><p class=\"p1\">The following initiatives, although not necessarily reflecting consensus at the regional level, were derived from the Dialogue, proposed in the interviews, discussed in the webinars, and polished during the convening as potential contributions for improving regional and global health architecture. Key reform proposals to reinforce the regional health architecture to this end included a regional platform for health cooperation (LAC Health Catalytic Platform, or LAC-HCP) and the creation of a regional health innovation hub (LAC Innovation Hub). <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-62a825d elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"62a825d\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-9a2a7ce exad-glass-effect-no exad-sticky-section-no\" data-id=\"9a2a7ce\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-a9a306a exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"a9a306a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">Box 4.<strong> LAC Innovation Hub<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-96f4912 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"96f4912\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">This proposal builds on the considerable capacities that already exist within countries across the region\u2014 capacities that are often underutilized or insufficiently recognized by others. Barriers such as limited platforms to showcase expertise, the absence of mechanisms to facilitate cross-country knowledge transfer, and inadequate financing for South\u2013South technical cooperation hinder their full potential. The LAC Innovation Hub would:  <\/p><ul><li class=\"p1\">Work through annual calls for proposals<\/li><li class=\"p1\">Establish regional priorities through a Regional Committee<\/li><li class=\"p1\">Leverage and expand existing capacities through structured country-to-country exchanges<\/li><li class=\"p1\">For instance, two countries in the region could submit a joint proposal to exchange knowledge and practical technical experience in digital information systems and interoperability or quality improvement in healthcare services.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-57d0226 elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"57d0226\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-c2df0a3 exad-glass-effect-no exad-sticky-section-no\" data-id=\"c2df0a3\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-829fea7 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-spacer\" data-id=\"829fea7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2ae38d9 elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"2ae38d9\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-51be08a exad-glass-effect-no exad-sticky-section-no\" data-id=\"51be08a\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-ec8b192 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"ec8b192\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">Box 5. <strong>LAC Health Catalytic Platform (LAC-HCP)<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8f6e146 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"8f6e146\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">This proposal advances the creation of a regional platform for health cooperation (LAC-HCP) to reshape and strengthen the region by fostering collaboration and enabling coordinated investment. The platform would operate as a unifying, non-duplicative mechanism, fully complementary to the mandates of PAHO, subregional mechanisms, and multilateral development banks. The platform would support two distinct but interconnected domains of cooperation:  <\/p><p class=\"p2\"><strong>Development of regional public goods (RPGs):<\/strong><\/p><ul><li class=\"p1\">Health data architectures, digital health standards, and interoperability<\/li><li class=\"p1\">Health technology assessment (HTA) methodologies and evidence platforms<\/li><li class=\"p1\">Shared generation and analytical capacities for AI-powered data-driven solutions for healthcare, research and surveillance, early warning systems, and policy implementation science<\/li><li class=\"p1\">Regional guidelines, capacity-building programs, and knowledge repositories accessible to all countries<\/li><\/ul><p> <\/p><p class=\"p1\"><strong>South-to-South cooperation for shared production and services (non-RPG goods):<\/strong><\/p><ul><li class=\"p2\">Joint\/ coordinated procurement of medicines, vaccines, diagnostics, and devices<\/li><li class=\"p2\">Regional manufacturing of pharmaceuticals, biologics, and other health goods<\/li><li class=\"p2\">Shared regulatory strengthening, pooled demand forecasting, and supply-chain integration<\/li><li class=\"p2\">Collaborative service models such as capacity building, technical assistance, or digital health deployments<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-caeadbb elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"caeadbb\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-b68cbac exad-glass-effect-no exad-sticky-section-no\" data-id=\"b68cbac\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-a09319b elementor-widget__width-initial exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"a09319b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">4. Unlock Sustainable Financing<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b998235 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"b998235\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">To ensure long-term, equitable, and efficient health system financing, reforms are needed to mobilize additional resources through innovative financing mechanisms, optimize resource use through strategic purchasing, and strengthen the contributions of global actors by improving the financial and governance architecture.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9a552c0 elementor-widget__width-initial exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"9a552c0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">4.1 Innovative Revenue Collecting Mechanisms<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-dfc9407 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"dfc9407\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<ul><li class=\"p1\"><strong>Taxes on harmful products:<\/strong> There is openness and broad consensus regarding the imposition of taxes on products harmful to health (tobacco, alcohol, sugary drinks, ultra-processed foods). This idea was discussed as a strategy to increase health revenue at the country level, as well as a way to contribute to a regional fund.\u00e7 <\/li><li><strong>New sources of regional revenue:<\/strong> Suggestions included increasing tourism-related taxes, taxing residual profits of large multinationals, and exploring a multilateral investment model applied to the health sector that generates dividends for participating countries.<\/li><li><strong>Local and regional philanthropy:<\/strong> Coordinate local philanthropic foundations (which currently invest only domestically) to support regional programs. Promote fiscal simplification of social responsibility schemes to boost local and regional philanthropy. <\/li><li><strong>Private investment and venture capital:<\/strong> Explore venture capital mechanisms for health innovations that can generate returns and promote reinvestment. The proposal calls for the integration of all sectors, including chambers of commerce, industry, and tourism. <\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-9b7035d elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"9b7035d\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-b44c6f0 exad-glass-effect-no exad-sticky-section-no\" data-id=\"b44c6f0\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2dc4ea0 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"2dc4ea0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">Box 6. <strong>Create the Catalytic Regional Solidarity Fund<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f7b160d exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"f7b160d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<ul><li class=\"p1\">The proposal envisions the creation of a pooled, catalytic financing mechanism in which multilateral development banks would coordinate and leverage existing regional health funds. The mechanism rests on three core principles. First, efficiency\u2014achieved through pooling resources from multiple donors, reducing administrative costs, and spreading financial risk. Second, solidarity\u2014by allocating funds where they are most needed to support regional functions and cooperation, particularly as many countries no longer qualify for traditional aid. Third, strengthened domestic commitment\u2014by using regional financing to bolster national investment in shared priorities and regional initiatives.    <\/li><li class=\"p1\">The mechanism could be capitalized through health-related taxes (e.g., on tobacco) and by redirecting surpluses or unutilized balances from existing multilateral projects, thereby expanding the region\u2019s capacity to finance joint actions and promote regional health outcomes. The fund should be governed by a board that includes country representatives and is hosted in one of the existing multilateral banks, to leverage their expertise in managing these types of initiatives. <\/li><li class=\"p1\">Although unclear, some potential uses for this fund include financing regional public health goods, generating a regional emergency response, and supporting regional market-shaping strategies or joint production of health goods and services.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2fcdb3f elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"2fcdb3f\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-b53e1f9 exad-glass-effect-no exad-sticky-section-no\" data-id=\"b53e1f9\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7d817ed elementor-widget__width-initial exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"7d817ed\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">4.2 Strategic Purchasing<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8a07090 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"8a07090\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<ul><li class=\"p1\"><p class=\"p1\"><strong>Loan guarantees as an effective credit-enhancement tool to lower borrowing costs for LAC countries:<\/strong> While some philanthropists already use this instrument, there is significant potential for expansion through regional philanthropists and multilateral banks\u2014e.g., the Inter-American Development Bank (IDB), the Development Bank of Latin America and the Caribbean (CAF), or the Central American Bank for Economic Integration (BCIE)\u2014to mobilize additional financing for health. Also, discuss the implementation of debt swaps or debt-for-development (D4D) swaps. <\/p><\/li><li class=\"p1\"><p class=\"p1\"><strong>Catalytic, results-based financing:<\/strong> Link financing to specific and measurable achievements in areas with high return on investment and associated with quality goals (e.g., surgical waiting times for breast cancer).<\/p><\/li><li class=\"p1\"><p class=\"p1\"><strong>Regional and contingency funds:<\/strong> Establish regional emergency funds to enable rapid response to health crises. This is one of the potential uses of the regional solidarity fund. Also, design pre-approved \u201cpeace-time\u201d instruments for pandemic response that can be activated immediately without negotiation during a crisis.  <\/p><\/li><li class=\"p1\"><p class=\"p1\"><strong>Shift health insurance models toward wellness and prevention:<\/strong> Shift from a treatment-only approach to one that actively funds and incentivizes wellness and preventive care, including routine check-ups. Although this requires initial investment, evidence shows it reduces long-term costs by lowering the burden of chronic disease. <\/p><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bfc80f2 elementor-widget__width-initial exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"bfc80f2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">4.3 Reform of Financial and Governance Architecture<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-dc6bf06 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"dc6bf06\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<ul><li class=\"p1\"><p class=\"p1\"><strong>Reform of multilateral banks:<\/strong> The concept of fair international financing was proposed, with participants emphasizing that institutions such as the World Bank, the IDB, and CAF should focus on long-term financing for structural reforms, rather than on isolated or short-term programs.<\/p><\/li><li class=\"p1\"><p class=\"p1\"><strong>Revision of graduation criteria:<\/strong> It is essential to review the use of income as the main criteria for eligibility of concessional financing or health assistance. The current system labels countries (such as SIDS) as high-income, without accounting for their particular vulnerabilities to climate change. <\/p><\/li><li class=\"p1\"><p class=\"p1\"><strong>Broaden the health agenda:<\/strong> Additionally, several participants emphasized the critical need to integrate health with the economic agenda. They recognized that health depends not only on economic stability but also actively contributes to growth, productivity, and social well-being, creating spillover benefits for education, employment, and social cohesion. <\/p><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-246bb91 elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"246bb91\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-1119479 exad-glass-effect-no exad-sticky-section-no\" data-id=\"1119479\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-aeba2ae elementor-widget__width-initial elementor-widget-mobile__width-initial exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"aeba2ae\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Reform Pathways<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7f39622 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"7f39622\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">The insights gathered through the dialogue point to several potential pathways for putting the proposed functions and institutional forms into practice. The proposed step-by-step reform process is ambitious, beginning with the recognition that incremental change from within the current global health institutions has repeatedly failed. Instead, the pathway must be regionally led and anchored in strong political commitments.  <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-21e893e elementor-widget__width-initial exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"21e893e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Step 1. Secure high-level political and financial leadership for reform <\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b4aeb1d exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"b4aeb1d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">The first step is to secure the political and financial levers needed to advance reform, recognizing that change will not come from within institutions that would need to give up power. The momentum must be generated by the region (not the regional \u201cinstitutions\u201d) and driven by political actors with the authority to push for global debates. This involves identifying and empowering high-level champions\u2014heads of government, influential ministers, and regional leaders such as the CARICOM lead head for health\u2014and equipping them to advocate for a LAC-driven reform agenda (e.g., at the Summit of Americas 2026, the World Health Assembly, the UN General Assembly, and the PAHO Directing Council Meeting). In parallel, the region must build durable political and financial coalitions that transcend electoral cycles. Engaging ministers of finance is essential to strengthen the economic case for health and ensure sustained support. To protect commitments over time, countries should explore legal or constitutional instruments that guarantee continuity and enable the creation or strengthening of regional mechanisms.     <\/p><p class=\"p1\">A critical component of this step is forging alliances beyond the region by identifying shared interests with other blocs and partnering with countries that carry weight in global forums such as the G20, G7, and BRICS. These alliances can amplify LAC\u2019s voice, expand political leverage, and help push for reforms in global spaces where the region is often underrepresented. Collectively, these actions create political ownership, financial backing, and international alignment required to drive and sustain a credible reform agenda. One strategy would be to leverage LAC\u2019s political visibility in these new health spaces at existing regional health conferences or summits such as the PAHO regional assembly or annual conferences of the World Bank, IDB, or CAF, among others.   <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a666f92 elementor-widget__width-initial exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"a666f92\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Step 2. LAC Health Catalytic Platform <\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5403bf3 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"5403bf3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">To prepare for implementation of a LAC Health Catalytic Platform (see Box 5), selected regional academic institutions should be commissioned to conduct a comprehensive stakeholder mapping, political economy analysis, and strategic roadmap, gathering insights from governments, civil society, private sector actors, and technical organizations. The platform\u2019s financing architecture will be sustained through catalytic resources, combining: (1) a trust fund or guarantee mechanism; (2) costing and financing strategies for RPGs; and; (3) enhanced joint procurement and regional production models. <\/p><p class=\"p1\">Funding would come from multilateral development banks (IDB, the World Bank, CAF), philanthropic organizations, and\u2014critically\u2014domestic funds from LAC countries, ensuring ownership, legitimacy, and long-term sustainability. Coordinating and pooling existing funds before jumping into looking for new sources can help generate resources for financing these initiatives. <\/p><p class=\"p1\">The LAC-HCP platform represents a transformative opportunity to build a more resilient, efficient, and collaborative regional health ecosystem that leverages shared strengths while generating goods and capacities that no single country could achieve on its own.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a41d265 elementor-widget__width-initial exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"a41d265\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Step 3. LAC Innovation Hub <\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c05f199 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"c05f199\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">To achieve the implementation of a LAC Innovation Hub (see Box 4), the following steps and milestones were proposed:<\/p><ul><li class=\"p1\">Based on the discussions held at the convening, the Dominican Republic, Colombia, and Brazil could initiate preliminary discussions with PAHO to launch and shape the design of the initiative.<\/li><li class=\"p1\">PAHO would serve as the technical and operational coordinator of this initiative through a dedicated, agile ad-hoc working group operating under the strategic mandate of a Regional Committee composed of governments, academia, and civil society, responsible for defining the annual regional priorities. The working group would identify institutions and governments interested in joining the Regional Committee. <\/li><li class=\"p1\">In line with the health exchange priorities set by the Regional Committee, a regional mapping of national experiences would be undertaken and consolidated into an Information Repository to facilitate systematic knowledge exchange.<\/li><li class=\"p1\">Annual calls for proposals would be issued to enable countries to identify shared priorities and apply as a tandem to provide and receive technical cooperation. The PAHO ad-hoc working group would develop the terms of reference for these calls. <\/li><\/ul><p class=\"p1\">This initiative requires dedicated funding and a transparent, participatory governance approach, with academia and civil society playing central roles in monitoring and evaluation (M&amp;E).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5f7d555 elementor-widget__width-initial exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"5f7d555\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Step 4. Sustainable financing for health <\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ad02c11 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"ad02c11\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">Improving health financing in the region requires a phased and pragmatic sequence of actions. The first step is to coordinate\/ optimize existing mechanisms by modernizing PAHO\u2019s Revolving Fund and Strategic Fund and expanding pooled procurement across regions, generating significant price reductions and demonstrating early progress towards improved access to quality drugs and medical devices. This can also be fostered by the establishment of the Regional Solidarity Fund. Simultaneously, countries can move toward sustainable domestic and regional revenue through innovative taxation\u2014such as sin taxes, tourism levies, and digital service taxes\u2014and channel a share of these resources into new regional health funds.    <br>With predictable public revenue in place, the region could safely mobilize private and non-traditional capital through public\u2013private partnerships, impact investment, pension fund allocations, and regional insurance schemes, widening the resource base for system strengthening. These flows should then be guided by performance-based financing, debt-reduction incentives, and earmarked allocations for prevention to ensure effective use of funds. Finally, long-term continuity requires anchoring reforms in legislation or regional agreements, decoupling financing from decision-making power, and redefining institutional roles so that global bodies focus on stewardship while regional actors lead implementation. Together, this sequence moves the region from quick wins to structural transformation and builds a financing system that is sustainable, autonomous, and aligned with LAC priorities.   <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ffb0609 elementor-widget__width-initial exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"ffb0609\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">To continue the global health architecture dialogue<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4a955c1 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"4a955c1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">Beyond these specific pathways, sustaining reform requires maintaining (post-reform) political engagement and regional coherence. Participants emphasized \u201cWithout real political influence, including presidents and finance ministers, it\u2019s difficult to influence national agendas.\u201d This necessitates empowering high-level champions, such as CARICOM\u2019s lead head for health and influential ministers, to advocate in regional summits (Mercosur, the Community of Latin American and Caribbean States [CELAC], SICA, the Andean Health Organization \u2013 Hip\u00f3lito Unanue [ORAS-CONHU]) and global forums (G7, G20, and the World Climate Summit [COP]).  <\/p><p class=\"p1\">Health must integrate with climate, trade, and economic strategy through \u201cHealth in All Policies\u201d frameworks linking finance, infrastructure, commerce, and environment ministries to health outcomes. Engaging civil society, academia, patient organizations, and the private sector requires transparent governance and accountability\u2014not \u201cdeclarations of good intentions.\u201d Anchoring reforms in legislation, decoupling financing from decision-making, and establishing binding mechanisms ensures continuity beyond political cycles. Engaging ministers of finance is especially critical to align health investments with macroeconomic goals and overcome persistent gaps in coordination.   <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-f09de66 elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"f09de66\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-25e2d2f exad-glass-effect-no exad-sticky-section-no\" data-id=\"25e2d2f\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e66d9f6 elementor-widget__width-initial exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"e66d9f6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Conclusion<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7278625 exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"7278625\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">LAC is well positioned to play a decisive role in shaping the next generation of global health reform. The region brings a long-standing tradition of solidarity, successful models of pooled procurement, strong public institutions, effective policies to counter commercial determinants of health, and deep experience managing health challenges across political and economic contexts. This collective leadership would allow the region to champion reforms that center equity, strengthen regional autonomy, and align global health priorities with the realities faced by unequal middle-income countries.  <\/p><p class=\"p1\">The global health crisis reflects a wider breakdown in geopolitics and international cooperation. It cannot be solved by one single sector (health) or a single country. Participants in the LAC dialogue noted that health outcomes are increasingly shaped by financial pressures, political tensions, requiring sustained engagement and collaboration, as well as broader governance reforms at national, regional, and global levels. Building this capacity is essential for ensuring that health concerns are integrated into broader policy debates and that the region can influence agendas that directly affect population health.   <\/p><p class=\"p1\">By advancing regional self-sufficiency, deepening South-South cooperation, and embedding health within broader economic and climate strategies, LAC can help drive a more balanced, responsive, and legitimate global health architecture. In doing so, the region can not only transform its own health future but contribute meaningfully to a global reform effort that benefits all regions. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-949f632 elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"949f632\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-b1175fb exad-glass-effect-no exad-sticky-section-no\" data-id=\"b1175fb\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-403633c exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"403633c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">Disclaimer: This paper captures the outcomes of one of five regional dialogues supported by the Wellcome Trust and led by regional partners. The views and opinions expressed throughout the dialogue are those of individual participants, and do not necessarily reflect the official policy or position of Wellcome. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-372f531a elementor-section-full_width elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"372f531a\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-6ec89f97 exad-glass-effect-no exad-sticky-section-no\" data-id=\"6ec89f97\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-12deb8b5 exad-sticky-section-no exad-glass-effect-no elementor-invisible elementor-widget elementor-widget-button\" data-id=\"12deb8b5\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeIn&quot;,&quot;_animation_delay&quot;:&quot;200&quot;,&quot;_animation_mobile&quot;:&quot;none&quot;}\" data-widget_type=\"button.default\">\n\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/lacforglobalhealth.org\/en\/reference-materials\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">\u2190 Back to Reference Materials<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-18dd2045 exad-glass-effect-no exad-sticky-section-no\" data-id=\"18dd2045\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>\u2190 Back to Reference Materials Dialogue Outcomes Document November 2025 Table of Contents Download PDF Foreword Working in global health over the past 40 years, I have come to see that the task of discussing how to reform the global health system is profoundly challenging. To start, we need to recognize that \u201cthe system\u201d exists [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":2382,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-3105","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/lacforglobalhealth.org\/en\/wp-json\/wp\/v2\/pages\/3105","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/lacforglobalhealth.org\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/lacforglobalhealth.org\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/lacforglobalhealth.org\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/lacforglobalhealth.org\/en\/wp-json\/wp\/v2\/comments?post=3105"}],"version-history":[{"count":7,"href":"https:\/\/lacforglobalhealth.org\/en\/wp-json\/wp\/v2\/pages\/3105\/revisions"}],"predecessor-version":[{"id":3173,"href":"https:\/\/lacforglobalhealth.org\/en\/wp-json\/wp\/v2\/pages\/3105\/revisions\/3173"}],"up":[{"embeddable":true,"href":"https:\/\/lacforglobalhealth.org\/en\/wp-json\/wp\/v2\/pages\/2382"}],"wp:attachment":[{"href":"https:\/\/lacforglobalhealth.org\/en\/wp-json\/wp\/v2\/media?parent=3105"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}