Sistemas de Salud en América Latina: Gobernanza, transformación y sostenibilidad para la equidad y la cobertura universal

Capítulo 1. Salud como derecho, bien público y campo político

[1] World Health Organization, Constitution of the World Health Organization, Geneva, Switzerland: WHO, 1948.

[2] United Nations, Universal Declaration of Human Rights. Paris, France: United Nations, 1948.

[3] United Nations, International Covenant on Economic, Social and Cultural Rights. New York, NY, USA: United Nations, 1966.

[4] World Health Organization and United Nations Children's Fund, Declaration of Alma-Ata: International Conference on Primary Health Care. Alma-Ata, Kazakhstan, 1978.

[5] World Health Organization, The Ottawa Charter for Health Promotion. Geneva, Switzerland: WHO, 1986.

[6] World Health Organization and United Nations Children's Fund, Declaration of Astana: Global Conference on Primary Health Care. Geneva, Switzerland: WHO, 2018.

[7] M. Marmot and R. G. Wilkinson, Eds., Social Determinants of Health, 2nd ed. Oxford, U.K.: Oxford University Press, 2006.

[8] V. Navarro, The Political and Social Contexts of Health. Amityville, NY, USA: Baywood Publishing, 2004.

[9] L. O. Gostin and B. M. Meier, "The origins and future of the right to health," The Lancet, vol. 393, no. 10176, pp. 1157-1159, 2019.

[10] D. Puras, "Universal Health Coverage: A Return to Alma-Ata and Ottawa," Health and Human Rights Journal, vol. 18, no. 2, pp. 7-10, 2016.

Capítulo 2. Modelos clásicos y reformas estructurales

[1] World Health Organization, The World Health Report 2000: Health Systems: Improving Performance. Geneva, Switzerland: WHO, 2000.

[2] World Health Organization, Everybody's Business: Strengthening Health Systems to Improve Health Outcomes: WHO's Framework for Action. Geneva, Switzerland: WHO, 2007.

[3] Pan American Health Organization, Health Systems and Financing: The Path to Universal Health Coverage. Washington, DC, USA: PAHO, 2021.

[4] OECD, Health at a Glance 2025: OECD Indicators. Paris, France: Organisation for Economic Cooperation and Development, 2025.

[5] E. Mossialos, A. Djordjevic, R. Osborn, and D. Sarnak, International Profiles of Health Care Systems. New York, NY, USA: The Commonwealth Fund, 2023.

[6] M. Reich, Political Analysis for Health Policy Reform. Washington, DC, USA: World Bank, 1995.

[7] T. R. Reid, The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. New York, NY, USA: Penguin Press, 2010.

[8] A. D. J. F. Giraldo, "Configuraciones, modelos de salud y enfoques basados en la Atención Primaria en Salud," Gerencia y Políticas de Salud, vol. 19, 2020.

[9] G. Vanegas, "La salud en la seguridad social. La reforma y los modelos de sistemas de salud," Revista Gerencia y Políticas de Salud, vol. 9, no. 19, pp. 111-129, 2010.

[10] Organisation for Economic Co-operation and Development and World Health Organization, OECD Reviews of Health Systems: Russian Federation 2012. Paris, France: OECD Publishing, 2012.

Capítulo 3. Financiamiento, eficiencia y sostenibilidad

[1] Organización Panamericana de la Salud (OPS), Financiamiento de los sistemas de salud. Washington, DC, USA: OPS, 2025. Disponible: https://www.paho.org/es/temas/financiamiento-sistemas-salud

[2] Comisión Económica para América Latina y el Caribe (CEPAL), La sostenibilidad financiera de los sistemas de salud en América Latina y el Caribe. Santiago, Chile: CEPAL, 2025. Disponible: https://repositorio.cepal.org/

[3] OECD y Banco Mundial, Panorama de la Salud: Latinoamérica y el Caribe 2020. París, Francia: OECD Publishing, 2020. doi: 10.1787/740f9640-es.

[4] Organización Mundial de la Salud (WHO), Global Monitoring Report on Universal Health Coverage 2023. Ginebra, Suiza: WHO, 2023.

[5] Organización Mundial de la Salud (WHO), World Health Report: Health Systems Financing—The Path to Universal Coverage. Ginebra, Suiza: WHO, 2010.

[6] Banco Mundial, Estudio del financiamiento de la salud. Washington, DC, USA: World Bank, 2008. Disponible: https://documents.worldbank.org/

[7] Organización para la Cooperación y el Desarrollo Económicos (OECD), Health at a Glance 2023: OECD Indicators. París, Francia: OECD Publishing, 2023.

[8] Organización Mundial de la Salud, Organización para la Cooperación y el Desarrollo Económicos y Banco Mundial, Delivering Quality Health Services: A Global Imperative for Universal Health Coverage. Ginebra, Suiza: WHO, OECD y World Bank, 2018.

[9] Centro de Investigación Económica y Presupuestaria (CIEP), Alternativas de financiamiento para el sector salud. Ciudad de México, México: CIEP, 2023.

[10] Health Financing Revisited: A Practitioner's Guide, Washington, DC, USA: Banco Mundial, 2006.

Capítulo 4. Transición epidemiológica y presión demográfica

[1] A. R. Omran, "The Epidemiologic Transition: A Theory of the Epidemiology of Population Change," The Milbank Quarterly, vol. 83, no. 4, pp. 731–757, 2005 (reimpresión del artículo original de 1971).

[2] World Health Organization, World Health Statistics 2025: Monitoring Health for the SDGs. Geneva, Switzerland: WHO, 2025.

[3] United Nations, World Population Prospects 2024. New York, NY, USA: United Nations Department of Economic and Social Affairs, Population Division, 2024.

[4] United Nations, World Population Ageing 2023. New York, NY, USA: United Nations Department of Economic and Social Affairs, Population Division, 2023.

[5] World Health Organization, Global Health Observatory (GHO). Geneva, Switzerland: WHO, 2025.

[6] J. Frenk, T. Frejka, B. Bobadilla, C. Stern, R. Lozano, J. M. Sepúlveda y M. José, "Elements for a Theory of the Health Transition," Health Transition Review, vol. 1, no. 1, pp. 21–38, 1991.

[7] P. A. Kuri-Morales, "La transición en salud y su impacto en la demanda de servicios," Gaceta Médica de México, vol. 147, no. 6, pp. 451-454, 2011.

[8] R. D. Gómez-Arias, "La transición en epidemiología y salud pública," Revista Facultad Nacional de Salud Pública, vol. 19, no. 2, pp. 99-111, 2001.

[9] Institute for Health Metrics and Evaluation, Global Burden of Disease Study 2023 (GBD 2023) Results. Seattle, WA, USA: IHME, 2024.

[10] The World Bank, World Development Indicators. Washington, DC, USA: World Bank, 2025.

Capítulo 5. Fragmentación estructural en América Latina

[1] Pan American Health Organization, The Urgency of Investing in Health Systems in Latin America and the Caribbean: Moving Towards More Resilient, Equitable and Sustainable Health Systems. Washington, DC, USA: PAHO, 2024.

[2] Organisation for Economic Co-operation and Development and World Bank, Health at a Glance: Latin America and the Caribbean 2023. Paris, France: OECD Publishing, 2023.

[3] Inter-American Development Bank, T. Bossert, B. Blanchet, and G. Koehlmoos, Comparative Review of Health System Integration in Selected Countries of Latin America. Washington, DC, USA: IDB, 2014.

[4] Eduardo Levcovitz and Maria Helena Costa Couto, Health Systems in Latin America in the 21st Century. Rio de Janeiro, Brazil: International Observatory of Human Capacities, Development and Public Policies, 2019.

[5] Economic Commission for Latin America and the Caribbean and Pan American Health Organization, Health and the Economy: A Convergence Needed to Address COVID-19 and Retake the Path of Sustainable Development in Latin America and the Caribbean. Santiago, Chile/Washington, DC, USA, 2020.

[6] Pan American Health Organization, Strategy for Universal Access to Health and Universal Health Coverage (CD53.R14). Washington, DC, USA: PAHO, 2014.

[7] World Health Organization, World Health Report 2010: Health Systems Financing—The Path to Universal Coverage. Geneva, Switzerland: WHO, 2010.

[8] Carolina A. Herrera et al., "No Time to Wait: Resilience as a Cornerstone for Primary Health Care in Latin America and the Caribbean," 2025.

[9] Economic Commission for Latin America and the Caribbean, "It Is Time to Transform Health Systems in Latin America and the Caribbean and Make Progress on Universality, Comprehensiveness, Sustainability and Resilience," 2022.

[10] Springer Nature, Integrated Care in Latin America. Cham, Switzerland: Springer Nature, 2025.

Capítulo 6. Cobertura universal y brechas regionales

[1] World Health Organization, Universal Health Coverage (UHC): Fact Sheet. Geneva, Switzerland: WHO, Dec. 2025. Disponible: https://www.who.int/es/news-room/fact-sheets/detail/universal-health-coverage-%28uhc%29

[2] Organización Panamericana de la Salud, Salud Universal. Washington, DC, USA: OPS, 2025. Disponible: https://www.paho.org/es/temas/salud-universal

[3] M. L. Marinho et al., Sistemas de salud universales, integrales, sostenibles y resilientes en América Latina y el Caribe. Santiago, Chile: Comisión Económica para América Latina y el Caribe (CEPAL), 2026.

[4] Comisión Económica para América Latina y el Caribe y Organización Panamericana de la Salud, La urgencia de invertir en los sistemas de salud en América Latina y el Caribe para reducir la desigualdad y alcanzar los Objetivos de Desarrollo Sostenible. Santiago, Chile: CEPAL/OPS, 2024.

[5] World Bank, Universal Health Coverage: Overview. Washington, DC, USA: The World Bank, 2025. Disponible: https://www.worldbank.org/es/topic/universalhealthcoverage

[6] Organisation for Economic Co-operation and Development and The World Bank, Health at a Glance: Latin America and the Caribbean 2020. Paris, France: OECD Publishing, 2020.

[7] D. Titelman, O. Cetrángolo, and O. Acosta, "La cobertura universal de salud en los países de América Latina: cómo mejorar los esquemas basados en la solidaridad," Revista CEPAL, no. 121, pp. 87–115, 2015.

[8] M. L. Marinho, A. Dahuabe, and A. Arenas de Mesa, Salud y desigualdad en América Latina y el Caribe: la centralidad de la salud para el desarrollo social inclusivo y sostenible. Santiago, Chile: CEPAL, 2023.

[9] Organisation for Economic Co-operation and Development, Health at a Glance 2023: OECD Indicators. Paris, France: OECD Publishing, 2023.

[10] World Health Organization, Tracking Universal Health Coverage: 2023 Global Monitoring Report. Geneva, Switzerland: World Health Organization and International Bank for Reconstruction and Development/The World Bank, 2023.

Capítulo 7. Infraestructura, recursos humanos y capacidad instalada

[1] Organization for Economic Co-operation and Development (OECD), The World Bank, Health at a Glance: Latin America and the Caribbean 2023. Paris, France: OECD Publishing, 2023.

[2] Organización Panamericana de la Salud (OPS), Política sobre el personal de salud 2030: fortalecimiento de los recursos humanos para la salud para lograr sistemas de salud resilientes. Washington, D.C., USA: OPS, 2024.

[3] World Health Organization (WHO), Global Strategy on Human Resources for Health: Workforce 2030. Geneva, Switzerland: WHO, 2016.

[4] World Health Organization, Organisation for Economic Co-operation and Development, and The World Bank, Delivering Quality Health Services: A Global Imperative for Universal Health Coverage. Geneva, Switzerland: WHO, 2018.

[5] World Bank, Building Resilient Health Systems in Latin America and the Caribbean: Lessons from the COVID-19 Pandemic. Washington, D.C., USA: World Bank, 2023.

[6] Organización Panamericana de la Salud, La salud universal en el siglo XXI: 40 años de Alma-Ata. Washington, D.C., USA: OPS, 2019.

[7] Inter-American Development Bank (IDB), Preparation of Health Investment Master Plans with a Network Approach: Projection of Services, Human Resources, Equipment and Infrastructure. Washington, D.C., USA: IDB, 2018.

[8] E. Báscolo, F. Hernández, y col., "Regulación y desempeño de los sistemas de salud en América Latina: desafíos para la gobernanza y la capacidad instalada," Revista Panamericana de Salud Pública, vol. 48, Art. e42, 2024.

[9] I. T. Peres, L. C. Braga, L. S. L. Bastos, and M. Villalobos-Cid, "Efficiency analysis of healthcare systems in Latin American and Caribbean countries: An application based on data envelopment analysis," Value in Health Regional Issues, vol. 40, pp. 101075, 2025.

[10] R. J. Cañarte Siguencia, M. F. Benavides Figueroa, G. B. S. Rosado Mora, C. L. García Arguello, and K. S. Arteaga Revelo, "Indicadores estructurales de la capacidad instalada de los sistemas de salud en América Latina, 2010–2020," Ciencia Latina Revista Científica Multidisciplinar, vol. 10, no. 1, 2026.

Capítulo 8. Resultados en salud: mortalidad, enfermedades crónicas y salud mental

[1] Comisión Económica para América Latina y el Caribe (CEPAL), It Is Time to Transform Health Systems in Latin America and the Caribbean and Make Progress on Universality, Comprehensiveness, Sustainability and Resilience, 2022.

[2] World Health Organization, Global Status Report on Noncommunicable Diseases 2022. Geneva, Switzerland: WHO, 2022.

[3] Pan American Health Organization, Health in the Americas+ 2022. Washington, DC: PAHO, 2022.

[4] World Health Organization, World Health Statistics 2025. Geneva, Switzerland: WHO, 2025.

[5] M. Marmot and R. G. Wilkinson, Eds., Social Determinants of Health, 2nd ed. Oxford, U.K.: Oxford University Press, 2006.

[6] World Health Organization, Global Health Observatory (GHO). Geneva, Switzerland: WHO, 2025.

[7] OECD, Health at a Glance 2023: OECD Indicators. Paris, France: OECD Publishing, 2023.

[8] Pan American Health Organization, The Burden of Mental Disorders in the Region of the Americas. Washington, DC: PAHO, 2022.

[9] Institute for Health Metrics and Evaluation, Global Burden of Disease Study 2023: Results. Seattle, WA: IHME, 2024.

[10] Secretaría de Salud de México, Enfermedades No Transmisibles: Situación y Propuestas de Acción. Una Perspectiva desde la Experiencia de México. Ciudad de México: Secretaría de Salud, 2018. Disponible: https://www.gob.mx/cms/uploads/attachment/file/416454/Enfermedades_No_Transmisibles_ebook.pdf

Capítulo 9. El posicionamiento internacional de los sistemas de salud latinoamericanos

[1] World Health Organization, World Health Report 2000: Health Systems: Improving Performance. Geneva, Switzerland: WHO, 2000.

[2] OECD and The World Bank, Health at a Glance: Latin America and the Caribbean 2020. Paris, France: OECD Publishing, 2020.

[3] Pan American Health Organization, Health in the Americas+ 2022. Washington, DC: PAHO, 2022.

[4] World Bank, World Development Indicators. Washington, DC, USA: World Bank, 2025.

[5] World Health Organization, Tracking Universal Health Coverage: 2023 Global Monitoring Report. Geneva, Switzerland: WHO and World Bank, 2023.

[6] E. Báscolo et al., "Regulation and performance of health systems," Revista Panamericana de Salud Pública, vol. 48, 2024.

[7] Organisation for Economic Co-operation and Development, Health at a Glance 2025: OECD Indicators. Paris, France: OECD Publishing, 2025.

[8] E. Levcovitz and M. H. C. Couto, "Health Systems in Latin America in the 21st Century," in Social Policies: Ideas, Experiences and Challenges, Rio de Janeiro, Brazil: Fundação Oswaldo Cruz, 2019.

[9] J. Fitzgerald et al., "Recommendations for the development of resilient health systems in Latin America and the Caribbean," Revista Panamericana de Salud Pública, vol. 47, Art. e101, 2023.

[10] The Lancet, The Lancet Global Health Commission on Financing Primary Health Care: Putting People at the Centre. London, UK: Elsevier, 2022.

Capítulo 10. El caso México: paradoja entre capacidad económica y desempeño sanitario

[1] M. A. González Block et al., Health Systems in Action (HSiA) Insights – Mexico, 2024. European Observatory on Health Systems and Policies, WHO Regional Office for Europe, 2025.

[2] World Health Organization, Health Systems for Health Security. Geneva: WHO, 2024.

[3] Pan American Health Organization, Health in the Americas+ 2022. Washington, DC: PAHO, 2022.

[4] OECD, Health at a Glance 2025: Mexico Country Note. Paris: OECD Publishing, 2025.

[5] Gobierno de México, Datos Abiertos COVID-19 México. Ciudad de México, 2024.

[6] Institute for Health Metrics and Evaluation (IHME), COVID-19 Projections: Mexico. University of Washington, 2024.

[7] GBD 2023 Demographics Collaborators, "Global age-sex-specific all-cause mortality and life expectancy estimates for 204 countries and territories, 1950–2023," The Lancet, vol. 406, no. 10513, pp. 1731–1810, 2025.

[8] National Academies of Sciences, Engineering, and Medicine, Understanding and Addressing Misinformation About Science. Washington, DC: National Academies Press, 2025.

[9] World Bank, Tracking Universal Health Coverage: 2023 Global Monitoring Report. Washington, DC: World Bank, 2023.

Capítulo 11. Ideologización, desinformación y credibilidad institucional en salud

[1] World Health Organization, Disinformation and Public Health. Geneva, Switzerland: WHO, 2024. Disponible: https://www.who.int/news-room/questions-and-answers/item/disinformation-and-public-health

[2] World Health Organization, The COVID-19 Infodemic. Geneva, Switzerland: WHO. Disponible: https://www.who.int/health-topics/infodemic

[3] World Health Organization Regional Office for Europe, Trust: The Foundation of Health Systems. Copenhagen, Denmark: WHO Europe, 2024.

[4] Organisation for Economic Co-operation and Development, Does Healthcare Deliver? Building Trustworthy 21st Century Healthcare Systems. Paris, France: OECD Publishing, 2024.

[5] King-Wa Fu et al., "Infodemic, Institutional Trust, and COVID-19 Vaccine Hesitancy: A Cross-National Survey," International Journal of Environmental Research and Public Health, vol. 19, no. 13, 2022.

[6] H. J. Larson, Stuck: How Vaccine Rumors Start—and Why They Don't Go Away. New York, NY, USA: Oxford University Press, 2020.

[7] United Nations Educational, Scientific and Cultural Organization, Journalism, Fake News & Disinformation: Handbook for Journalism Education and Training. Paris, France: UNESCO, 2018.

[8] C. Wang, S. T. Y. Choi, K. W. Fu, et al., "Health misinformation and institutional trust: Emerging evidence from global health crises," International Journal of Environmental Research and Public Health, vol. 19, 2022.

[9] Organisation for Economic Co-operation and Development, Enhancing Public Trust in COVID-19 Vaccination: The Role of Governments. Paris, France: OECD Publishing, 2021.

[10] World Health Organization, Managing the COVID-19 Infodemic: Promoting Healthy Behaviours and Mitigating the Harm from Misinformation and Disinformation. Geneva, Switzerland: WHO, 2020.

Capítulo 12. Gobernanza, libertad institucional y calidad de la información sanitaria

[1] World Health Organization, Guidance for Health Information System Governance. Copenhagen, Denmark: WHO Regional Office for Europe, 2021.

[2] World Health Organization, Health Systems Governance. Geneva, Switzerland: WHO, 2025.

[3] World Health Organization, Governance for Public Health Across the Health and Allied Sectors: A Report to Guide Country-Level Institutional Capacity for Essential Public Health Functions Underpinning Multisectoral Approaches. Geneva, Switzerland: WHO, 2025.

[4] World Health Organization, Progression Pathway for Governance of Mixed Health Systems. Geneva, Switzerland: WHO, 2025.

[5] OECD, Facts Not Fakes: Tackling Disinformation, Strengthening Information Integrity. Paris, France: OECD Publishing, 2024. doi: 10.1787/ff96d19f-en.

[6] OECD, Hechos frente a falsedades: Fortaleciendo la democracia a través de la integridad de la información. París, Francia: OECD Publishing, 2024. doi: 10.1787/06f8ca41-es.

[7] D. W. Brinkerhoff and T. Bossert, "Health governance: principal–agent linkages and health system strengthening," Health Policy and Planning, vol. 29, no. 6, pp. 685–693, 2014.

[8] E. Mossialos, A. Wenzl, R. Osborn, and C. Anderson (eds.), International Profiles of Health Care Systems. New York, NY, USA: The Commonwealth Fund, 2023.

[9] World Bank, Worldwide Governance Indicators (WGI): Documentation. Washington, DC, USA: World Bank, 2025.

[10] European Observatory on Health Systems and Policies, Strengthening Health System Governance: Better Policies, Stronger Performance. Copenhagen, Denmark: WHO Regional Office for Europe, 2016.

Capítulo 13. COVID-19 y fragilidades estructurales en América Latina

[1] S. G. Litewka and E. Heitman, "Latin American healthcare systems in times of pandemic," Developing World Bioethics, vol. 20, no. 2, pp. 69–73, 2020.

[2] A. Lal, N. Erondu, D. L. Heymann, G. Gitahi, and R. Yates, "Fragmented health systems in COVID-19: Rectifying the misalignment between global health security and universal health coverage," The Lancet, vol. 397, no. 10268, pp. 61–67, 2021.

[3] C. F. Etienne, "Tackling Latin America's COVID-19 emergency requires greater solidarity," The Lancet, vol. 398, no. 10304, pp. 951–952, 2021.

[4] Pan American Health Organization, Contributions of the New Framework for Essential Public Health Functions to Addressing the COVID-19 Pandemic. Washington, DC: PAHO, 2022.

[5] Pan American Health Organization, Building Resilient Health Systems to Advance Towards Universal Health in the Region of the Americas: Lessons from COVID-19. Washington, DC: PAHO, 2022.

[6] OECD and World Bank, Health at a Glance: Latin America and the Caribbean 2023. Paris: OECD Publishing, 2023.

[7] P. C. Saturno-Hernández et al., "COVID-19 pandemic: A call to action for health systems in Latin America to strengthen quality of care," International Journal for Quality in Health Care, vol. 33, no. 1, 2021.

[8] C. dos Santos et al., "COVID-19 in Latin America: Inequalities and response capacity of health systems to health emergencies," Pan American Journal of Public Health, vol. 47, e88, 2023.

[9] Economic Commission for Latin America and the Caribbean (ECLAC) and Pan American Health Organization, The Urgency of Investing in Health Systems in Latin America and the Caribbean. Santiago/Washington, DC: ECLAC–PAHO, 2024.

[10] J. Frenk et al., "No time to wait: Resilience as a cornerstone for primary health care across Latin America and the Caribbean," The Lancet Regional Health – Americas, vol. 41, 2025.

Capítulo 14. Exceso de mortalidad y sistemas de información

[1] V. Knutson, S. Aleshin-Guendel, A. Karlinsky, W. Msemburi, and J. Wakefield, "Estimating global and country-specific excess mortality during the COVID-19 pandemic," World Health Organization, Geneva, Switzerland, 2022.

[2] World Health Organization, Methods for Estimating the Excess Mortality Associated with the COVID-19 Pandemic, Geneva, Switzerland, 2022.

[3] World Health Organization, "Global excess deaths associated with COVID-19, January 2020–December 2021," WHO Data Stories, Geneva, Switzerland, 2022.

[4] D. Morgan, J. Ino, G. Di Paolantonio, and F. Murtin, "Excess mortality: Measuring the direct and indirect impact of COVID-19," OECD Health Working Papers, no. 122, OECD Publishing, Paris, France, 2020.

[5] OECD, Health at a Glance 2021: OECD Indicators, Paris, France: OECD Publishing, 2021.

[6] OECD and The World Bank, Health at a Glance: Latin America and the Caribbean 2023, Paris, France: OECD Publishing, 2023.

[7] H. Wang et al., "Estimating excess mortality due to the COVID-19 pandemic: A systematic analysis of COVID-19-related mortality, 2020–2021," The Lancet, vol. 399, no. 10334, pp. 1513–1536, 2022.

[8] World Health Organization, "Exceso mundial de muertes asociado a la pandemia de COVID-19," Preguntas y respuestas, Geneva, Switzerland, 2025.

[9] The World Bank, SDG Atlas 2023: Good Health and Well-being, Washington, DC, USA: World Bank, 2023.

[10] A. Comas-García and A. Erdely, "A polynomial regression model for excess mortality in Mexico 2020–2022 due to the COVID-19 pandemic," 2023.

Capítulo 15. Confianza institucional post-pandemia

[1] World Health Organization, WHO Initiative on Trust and Pandemic Preparedness. Geneva, Switzerland: WHO, 2024. Disponible: https://www.who.int/initiatives/who-initiative-on-trust-and-pandemic-preparedness

[2] OECD, Encuesta de la OCDE sobre los determinantes de la confianza en las instituciones públicas de América Latina y el Caribe: Resultados 2025. Paris, France: OECD Publishing, 2025. doi:10.1787/b4dea13c-es.

[3] OECD, La confianza y las percepciones sobre las interacciones cotidianas con las instituciones públicas. Paris, France: OECD Publishing, 2025.

[4] World Health Organization, Measuring Integrated Delivery of Essential Public Health Functions: A Review of Health Systems and Health Security Monitoring Tools. Geneva, Switzerland: WHO, 2026.

[5] World Health Organization, Achieving Well-being: A Global Framework for Integrating Well-being into Public Health Using a Health Promotion Approach. Geneva, Switzerland: WHO, 2024.

[6] OECD, Panorama general: Encuesta de la OCDE sobre los determinantes de la confianza en las instituciones públicas de América Latina y el Caribe. Paris, France: OECD Publishing, 2025.

[7] OECD, Trust in Government on Complex Policy Issues. Paris, France: OECD Publishing, 2025.

[8] Edelman, 2025 Edelman Trust Barometer: Global Report. New York, NY, USA: Edelman, 2025.

[9] Latinobarómetro Corporation, Informe Latinobarómetro 2024. Santiago, Chile: Corporación Latinobarómetro, 2024.

[10] United Nations Development Programme (UNDP), Governance for Resilient Human Development. New York, NY, USA: UNDP, 2022.

Capítulo 16. Educación STEM y desarrollo sanitario

[1] World Health Organization, Global Strategy on Human Resources for Health: Workforce 2030. Geneva, Switzerland: World Health Organization, 2016.

[2] World Health Organization, Health Workforce Education Technology Assessment: Background Research Report. Geneva, Switzerland: World Health Organization, 2023.

[3] World Health Organization, Digitalized Health Workforce Education: An Elicitation of Research Gaps and Selection of Case Studies. Geneva, Switzerland: World Health Organization, 2023.

[4] World Health Organization, Integrating the Social Determinants of Health into Health Workforce Education and Training. Geneva, Switzerland: World Health Organization, 2023.

[5] Organisation for Economic Co-operation and Development (OECD) and International Labour Organization (ILO), Equipping Health Workers with the Right Skills: Skills Anticipation in the Health Workforce. Paris, France: OECD Publishing, 2022.

[6] Organisation for Economic Co-operation and Development (OECD) and International Labour Organization (ILO), Flexible Learning Pathways into Healthcare Occupations. Paris, France: OECD Publishing, 2026.

[7] Organisation for Economic Co-operation and Development (OECD), Health in the 21st Century: Putting Data to Work for Stronger Health Systems. Paris, France: OECD Publishing, 2019.

[8] United Nations Educational, Scientific and Cultural Organization (UNESCO), Engineering for Sustainable Development: Delivering on the Sustainable Development Goals. Paris, France: UNESCO Publishing, 2021.

[9] United Nations Educational, Scientific and Cultural Organization (UNESCO), UNESCO Science Report: The Race Against Time for Smarter Development. Paris, France: UNESCO Publishing, 2021.

[10] Inter-American Development Bank, The Future of Digital Health in Latin America and the Caribbean. Washington, DC, USA: Inter-American Development Bank, 2020.

[11] Inter-American Development Bank, Digital Transformation of the Health Sector in Latin America and the Caribbean. Washington, DC, USA: Inter-American Development Bank, 2024.

[12] Pan American Health Organization, The Digital Transformation of the Health Sector in the Region of the Americas. Washington, DC, USA: Pan American Health Organization, 2022.

[13] Siemens Stiftung, STEM Education Programmes for Latin America: Annual Report 2024. Munich, Germany: Siemens Stiftung, 2024.

Capítulo 17. Innovación tecnológica, biotecnología y política pública

[1] World Health Organization, Scaling Innovations in Public Health Systems: Guidance and Toolkit. Geneva: WHO, 2026.

[2] World Health Organization, World Intellectual Property Organization, and World Trade Organization, Promoting Access to Medical Technologies and Innovation: Intersections Between Public Health, Intellectual Property and Trade, 2nd ed. Geneva: WHO, 2020.

[3] World Health Organization, Global Research Agenda on Knowledge Translation and Evidence-Informed Policy-Making. Geneva: WHO, 2026.

[4] Organización Panamericana de la Salud, Agenda de Salud Sostenible para las Américas 2018–2030. Objetivo 7: Generación, transferencia y uso de evidencia y conocimiento en salud. Washington, DC: OPS, 2021.

[5] Organización para la Cooperación y el Desarrollo Económicos (OECD), Anticipatory Governance for Responsible Innovation in Synthetic Biology. Paris: OECD Publishing, 2026.

[6] Comisión Económica para América Latina y el Caribe (CEPAL), Ciencia, tecnología e innovación: cooperación, integración y desafíos regionales. Santiago: CEPAL, 2022.

[7] Comisión Económica para América Latina y el Caribe (CEPAL), Políticas de ciencia, tecnología e innovación para el desarrollo productivo. Panorama de las Políticas de Desarrollo Productivo en América Latina y el Caribe 2025. Santiago: CEPAL, 2026.

[8] Organización Mundial de la Salud, Salud pública, innovación y derechos de propiedad intelectual: Informe de la Comisión de Derechos de Propiedad Intelectual, Innovación y Salud Pública. Geneva: WHO, 2006.

[9] OECD, The OECD Innovation Strategy: Getting a Head Start on Tomorrow. Paris: OECD Publishing, 2010.

[10] D. Rotolo, D. Hicks, and B. R. Martin, "What Is an Emerging Technology?," Research Policy, vol. 44, no. 10, pp. 1827–1843, 2015.

[11] A. M. Petersen, D. Rotolo, and L. Leydesdorff, "A Triple Helix Model of Medical Innovation: Supply, Demand and Technological Capabilities," Scientometrics, 2016.

[12] L. Leydesdorff, The Knowledge-Based Economy and the Triple Helix Model, 2012.

Capítulo 18. Digitalización, IA y sistemas de información en salud

[1] World Health Organization, Global Strategy on Digital Health 2020–2025. Geneva, Switzerland: WHO, 2021.

[2] Pan American Health Organization, Health Information Systems. Washington, DC, USA: PAHO, 2025.

[3] Pan American Health Organization, Information Systems and Digital Health (IS4H). Washington, DC, USA: PAHO, 2025.

[4] Pan American Health Organization, Artificial Intelligence for Health. Washington, DC, USA: PAHO, 2025.

[5] OECD and World Bank, Health at a Glance: Latin America and the Caribbean 2023. Paris, France: OECD Publishing, 2023.

[6] OECD, Digital Health. Paris, France: Organisation for Economic Co-operation and Development, 2025.

[7] Pan American Health Organization, Digital Health and Information Systems. Washington, DC, USA: PAHO, 2025.

[8] Pan American Health Organization, Evidence and Intelligence for Action in Health. Washington, DC, USA: PAHO, 2025.

[9] T. Oliveira Hashiguchi, The COVID-19 Pandemic and the Future of Telemedicine. Paris, France: OECD Publishing, 2023.

[10] A. Periáñez et al., "The Digital Transformation in Health: How AI Can Improve the Performance of Health Systems," arXiv preprint arXiv:2409.16098, 2024.

[11] T. Shaik et al., "Remote Patient Monitoring Using Artificial Intelligence: Current State, Applications, and Challenges," Artificial Intelligence in Medicine, vol. 138, 2023.

[12] V. Tresp et al., "Going Digital: A Survey on Digitalization and Large Scale Data Analytics in Healthcare," Proceedings of the IEEE, vol. 104, no. 11, pp. 2180–2206, 2016.

Capítulo 19. Corrupción, eficiencia y gasto sanitario

[1] World Health Organization, Improving Health System Efficiency: Reforms for Improving the Efficiency of Health Systems. Geneva, Switzerland: WHO, 2015.

[2] OECD, Tackling Wasteful Spending on Health. Paris, France: OECD Publishing, 2017.

[3] OECD and The World Bank, Health at a Glance: Latin America and the Caribbean 2020. Paris, France: OECD Publishing, 2020.

[4] OECD, Health Systems Characteristics: A Survey of 21 Latin American and Caribbean Countries. OECD Health Working Papers No. 111. Paris, France: OECD Publishing, 2019.

[5] World Health Organization, Reducing Health System Corruption: Anti-Corruption, Transparency and Accountability for Health. Geneva, Switzerland: WHO, 2023.

[6] E. Savedoff and W. Hussmann, "Why are health systems prone to corruption?" in Global Corruption Report 2006: Corruption and Health, Berlin, Germany: Transparency International/Cambridge University Press, 2006, pp. 4–16.

[7] Transparency International, Corruption Perceptions Index 2025. Berlin, Germany: Transparency International, 2026.

[8] World Bank, Governance and Institutions for Health System Performance. Washington, DC, USA: World Bank, 2022.

[9] D. Cotlear, Ed., Going Universal: How 24 Developing Countries Are Implementing Universal Health Coverage Reforms from the Bottom Up. Washington, DC, USA: World Bank, 2015.

[10] Pan American Health Organization, Health in the Americas 2022. Washington, DC, USA: PAHO, 2022.

Capítulo 20. Atención primaria renovada como eje regional

[1] World Health Organization, Primary Health Care. Geneva, Switzerland: WHO, 2025. Disponible: https://www.who.int/news-room/fact-sheets/detail/primary-health-care

[2] World Health Organization, Implementing the Primary Health Care Approach: A Synthesis of the Primer. Geneva, Switzerland: WHO, 2025.

[3] World Health Organization, Evaluation of the WHO Special Programme on Primary Health Care: Executive Summary. Geneva, Switzerland: WHO, 2025.

[4] Organización Panamericana de la Salud, Alianza por la Atención Primaria de Salud en las Américas: Documento Marco. Washington, DC: OPS, 2023.

[5] Organización Panamericana de la Salud, Avances hacia la Salud Universal en la Región de las Américas: Abordar las necesidades insatisfechas de atención de salud mediante la Atención Primaria de Salud. Washington, DC: OPS, 2025.

[6] Organización Panamericana de la Salud, Actualización del marco conceptual y operacional para las Redes Integradas de Servicios de Salud (RISS): Consenso técnico OPS–BID–Banco Mundial. Washington, DC: OPS, 2025.

[7] Organización Panamericana de la Salud, Declaración Regional sobre las Nuevas Orientaciones de la Atención Primaria de Salud (Declaración de Montevideo). Washington, DC: OPS, 2005.

[8] Organización Panamericana de la Salud, Atención Primaria de Salud en las Américas: Las enseñanzas extraídas a lo largo de 25 años y los retos futuros. Washington, DC: OPS, 2003.

[9] Comisión Lancet Regional Health–Américas, Banco Mundial y Organización Panamericana de la Salud, No Time to Wait: Resilience as a Cornerstone for Primary Health Care Across Latin America and the Caribbean. Washington, DC, 2025.

[10] World Health Organization and UNICEF, A Vision for Primary Health Care in the 21st Century: Towards Universal Health Coverage and the Sustainable Development Goals. Geneva, Switzerland: WHO, 2018.

[11] Organización Mundial de la Salud, Declaración de Astaná sobre Atención Primaria de Salud. Geneva, Switzerland: WHO, 2018.

[12] Organización Mundial de la Salud, Primary Health Care Measurement Framework and Indicators: Monitoring Health Systems through a Primary Health Care Lens. Geneva, Switzerland: WHO, 2022.

Capítulo 21. Integración regional sanitaria

[1] Organización Panamericana de la Salud (OPS), Redes integradas de servicios de salud: Actualización del marco conceptual y operacional para la Región de las Américas. Washington, DC: OPS, 2025.

[2] Organización Panamericana de la Salud (OPS), Redes Integradas de Servicios de Salud: un marco actualizado para fortalecer la integración y la equidad en las Américas. Washington, DC: OPS, 2026.

[3] Comisión Económica para América Latina y el Caribe (CEPAL) y Organización Panamericana de la Salud (OPS), La urgencia de invertir en los sistemas de salud en América Latina y el Caribe para reducir la desigualdad y alcanzar los Objetivos de Desarrollo Sostenible. Santiago de Chile: CEPAL, 2024.

[4] Comisión Económica para América Latina y el Caribe (CEPAL), Lineamientos y propuestas para un plan de autosuficiencia sanitaria para América Latina y el Caribe. Santiago de Chile: CEPAL, 2021.

[5] Organización Panamericana de la Salud (OPS), CD60/INF/11 C. Organizaciones de integración subregional. Washington, DC: OPS, 2023.

[6] Comisión Económica para América Latina y el Caribe (CEPAL), Integración regional: hacia una estrategia de cadenas de valor inclusivas. Santiago de Chile: CEPAL, 2014.

[7] Organización Mundial de la Salud (OMS), Estructura organizativa de la Organización Mundial de la Salud. Ginebra: OMS.

[8] Organización Mundial de la Salud (OMS), Cobertura sanitaria universal y fortalecimiento de los sistemas de salud. Ginebra: OMS, 2023.

[9] Organización Panamericana de la Salud (OPS), Funciones Esenciales de Salud Pública: Estrategia para fortalecer las funciones esenciales de salud pública 2024–2034. Washington, DC: OPS, 2024.

[10] Naciones Unidas, Transformar nuestro mundo: la Agenda 2030 para el Desarrollo Sostenible. Nueva York: Naciones Unidas, 2015.

Capítulo 22. Reforma estructural para sistemas universales integrados

[1] World Health Organization, Health Reform Manual: Eight Practical Steps. Geneva, Switzerland: WHO, 2026.

[2] World Health Organization, Improving Public Health in Health Systems: Guidance for Country-Level Policies and Actions. Geneva, Switzerland: WHO, 2026.

[3] Organización Panamericana de la Salud, Actualización del marco conceptual y operacional para las Redes Integradas de Servicios de Salud (RISS): Consenso técnico de la OPS, el BID y el Banco Mundial. Washington, DC, USA: OPS, 2025.

[4] Organización Panamericana de la Salud, Ampliación del acceso equitativo a los servicios de salud: Recomendaciones para la transformación de los sistemas de salud hacia la salud universal. Washington, DC, USA: OPS, 2022.

[5] Organización Panamericana de la Salud, Redes Integradas de Servicios de Salud (RISS): Actualización del marco conceptual y operacional para la Región de las Américas. Washington, DC, USA: OPS, 2025.

[6] World Health Organization, Reforms for Improving the Efficiency of Health Systems: Lessons from 10 Country Cases. Geneva, Switzerland: WHO, 2015.

[7] World Health Organization, Building up the National Integrated Health System: Uruguay Case Study. Geneva, Switzerland: WHO, 2015.

[8] World Bank, Going Universal: How 24 Developing Countries Are Implementing Universal Health Coverage Reforms. Washington, DC, USA: World Bank, 2015.

[9] Organisation for Economic Co-operation and Development (OECD), Expanding Social Protection and Addressing Informality in Latin America: Reforming the Health System in Mexico. Paris, France: OECD, 2025.

[10] World Health Organization, Universal Health Coverage (UHC). Geneva, Switzerland: WHO.

Capítulo 23. Marco estratégico 2030–2040

[1] World Health Organization, Universal Health Coverage. Geneva, Switzerland: WHO, 2025. Disponible: https://www.who.int/health-topics/universal-health-coverage

[2] World Health Organization, Health Systems Governance. Geneva, Switzerland: WHO, 2025. Disponible: https://www.who.int/health-topics/universal-health-coverage/health-systems-governance

[3] World Health Organization, Achieving Well-being: A Global Framework for Integrating Well-being into Public Health Using a Health Promotion Approach. Geneva, Switzerland: WHO, 2024.

[4] World Health Organization, Access to Safe, Effective and Quality-Assured Health Products and Technologies: Roadmap for WHO Action 2025–2030. Geneva, Switzerland: WHO, 2025.

[5] United Nations, Transforming Our World: The 2030 Agenda for Sustainable Development. New York, NY, USA: United Nations, 2015.

[6] Pan American Health Organization, Strategy for Universal Access to Health and Universal Health Coverage. Washington, DC, USA: PAHO.

[7] Organisation for Economic Co-operation and Development, Health at a Glance: Latin America and the Caribbean 2020. Paris, France: OECD Publishing, 2020.

[8] GBD 2021 Collaborators, "Global burden of diseases, injuries, and risk factors 1990–2021," The Lancet, 2024.

[9] World Bank, Healthy Development: The World Bank Strategy for Health, Nutrition and Population. Washington, DC, USA: World Bank.

[10] The Lancet Commission on Primary Health Care and Resilience in Latin America and the Caribbean, No Time to Wait: Resilience as a Cornerstone for Primary Health Care Across Latin America and the Caribbean, 2025.