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Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
Health Systems in South America: challenges to the universality, integrality and equity
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Health Systems in South America: challenges to the universality, integrality and equity

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O livro “Sistemas de Saúde na América do Sul: desafios para a universalidade, a integralidade e a equidade” foi apresentado em 6 de setembro de 2012, por ocasião da VII Reunião do Conselho de Saúde …

O livro “Sistemas de Saúde na América do Sul: desafios para a universalidade, a integralidade e a equidade” foi apresentado em 6 de setembro de 2012, por ocasião da VII Reunião do Conselho de Saúde Sul-americano, instância da Unasul que reúne os 12 Ministros de Saúde do bloco, ao qual o Isags é vinculado.

A publicação está organizada em uma Introdução do Diretor-Executivo do ISAGS, o ex-Ministro da Saúde do Brasil José Gomes Temporão, e 14 capítulos. No capítulo 1, é feita uma análise transversal dos Sistemas de Saúde dos países da América do Sul e dos desafios à universalização da cobertura sanitária na região. Os 12 capítulos seguintes, referentes a cada um dos países da Unasul, foram redigidos com base nas contribuições feitas pelos próprios governos a partir de um guia metodológico composto de 11 dimensões, elaborado colaborativamente pelos países. E, por fim, é feita uma análise a respeito da cooperação regional com vistas à universalização da cobertura em Saúde e das vantagens e debilidades da Unasul para esse processo.

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  • 1. Health Systems in South America: Challenges to the universality, integrality and equity
  • 2. SOUTH AMERICAN INSTITUTE OF GOVERNMENT IN HEALTH Executive Director José Gomes Temporão Technical Coordinator Henri Jouval MINISTERS OF HEALTH IN SOUTH AMERICA IN MAY 2012 Juan Luis Manzur - Argentina Juan Carlos Calvimontes - Bolivia Alexandre Padilha - Brazil Jaime Mañalich - Chile Beatriz Londoño - Colombia Carina Vance - Ecuador Bheri Ramsaran - Guyana Esperanza Martínez - Paraguay Carlos Alberto Tejada - Peru Jorge Venegas - Uruguay Michel Blokland - Suriname Eugenia Sader - Venezuela ISAGS EDITORIAL COUNCIL Ernesto Báscolo Juan Eduardo Guerrero Juan Garay Laura Nervi Lígia Giovanella Luis Beingolea Paulo Buss
  • 3. May 2012 Health Systems in South America: Challenges to the universality, integrality and equity
  • 4. Copyright @ 2012 ISAGS Organized by: Ligia Giovanella Oscar Feo Mariana Faria Sebastián Tobar Text translation and review: Jorge Davidson Cover and Graphic Design: Carlota Rios Editing and images: Carlota Rios and Robson Lima Photographs: Radilson Carlos Gomes Support: Amaro Grassi, Flávia Bueno, Laura Santana, Luana Bermudez, Mariana Theophilo Cataloguing-in-Source 614 S622 2012 Support: Fundação para o Desenvolvimento Científico e Tecnológico em Saude (Fiotec), Fundação Oswaldo Cruz (Fiocruz), Ministerio da Saúde Brasil ISAGS Contacts Av. Nilo Peçanha, 38 – 5° andar – Centro 20020-100 – Rio de Janeiro – RJ Telephones: +5521 2215-1858 Fax: +5521 2215-6347 e-mail: isags@isags-unasur.org www.isags-unasur.org Health Systems in South America: Challenges to the universality, integrality and equity / South American Institute of Government in Health, Ligia Giovanella, Oscar Feo, Mariana Faria, Sebastián Tobar (orgs.). Rio de Janeiro: ISAGS, 2012 852 P. ISBN 978-85-87743-20-6 1. Public Health. 2. Health Systems. I. South American Institute of Government in Health. II. Giovanella, Ligia (org.). III. Feo, Oscar (org.). IV. Faria, Mariana (org.). V. Tobar, Sebastián (org.).
  • 5. Index Prologue 8 Presentation 9 Introduction: Universal Health Systems for a World in Transformation 13 I. Health Systems in South America 21 II. Health System in Argentina 70 III. Health System in Bolivia 159 IV. Health System in Brazil 223 V. Health System in Chile 290 VI. Health System in Colombia 340 VII. Health System in Ecuador 431 VIII. Health System in Guyana 504 IX. Health System in Paraguay 541 X. Health System in Peru 588 XI. Health System in Suriname 669 XII. Health System in Uruguay 711 XIII. Health System in Venezuela 760 XIV. International Cooperation in the Building of Universal Health Systems within UNASUR: Strengths and Weaknesses 795 ISAGS Guide to Direct the Critical Analysis of Health Systems in South America 827 Participants to the Opening Workshop of the South American Institute of Government in Health 833 Participants to the Meeting of the Executive Committee in ISAGS Opening Ceremony 834 National Coordinators of the South American Health Council 834
  • 6. Prologue In the process of enacting a mandate arising from the meeting of Heads of State of the Union of South American Nations (UNASUR), the Ministers of Health of the 12 Member States of the recently created organization met for the first time in April 2009 in the city of Santiago, Chile as the Health Council of UNASUR. At this memorable meeting the bases were set for what would become, the following year in Cuenca, the Quinquennial Plan (2010 – 2015) of the UNASUR Health Council. At this meeting in Santiago, Brazil launched for the first time the idea of creating a health institute to promote training, research and technical cooperation that would support each Member State and the Union of Nations as a whole to measure the quality of intersectoral governance in health. Health is one of the main social policies of any government and legitimacy of governments is always dependent upon the good performance in the social sector, particularly in terms of health. A good government in health contributes to broaden the governability of young democracies being implemented in South America. It was therefore critical that the Health Council of Unasur could serve as support to each and every government of the Member States in the dissemination and exchange of successful health governance experiences. To fully meet those general objectives it was critical to create the South American Institute of Government in Health (ISAGS). As institute of government in health for South America, it was important that it had as an objective the formation of leadership, technical support to health systems and also the management of existing knowledge, creating new knowledge when necessary and placing this information at the disposal of health authorities in South America. In this sense, one of the first initiatives was the study and subsequent workshop on health system governance in UNASUR nations that resulted in the publication of this book that you are now reading.
  • 7. 8 HEALTH SYSTEMS IN SOUTH AMERICA At a time when multilateralism is under challenge to prove its usefulness, as noted in the criticisms to the United Nations System that has recently celebrated 60 years, Unasur emerges to reassert the importance of organizations of this nature. Trends towards multipolarity in today’s world are gaining prominence, the centrality of hegemonic power is becoming void of significance, and regionalism is acquiring historical significance. A new political and economic scenario has been emerging over the last few years with the creation of Unasur, The Bolivarian Alternative for the Americas (ALBA) and, more recently, the Community of Latin American and Caribbean States (CELAC) that actually encompasses Unasur, the Caribbean Community (CARICOM) and the System of Central American Integration (SICA). Development, reduction of asymmetries, fight against poverty, trade in local currencies, alternative to the U.S. dollar, physical and energy integration, and sovereignty (dietary and nutritional, infrastructural, energetic, productive, scientific, cultural, military and also in health) became the key principles of the new and rising paradigm. Other essential key ideas are joint international action and good governance. The Health Ministers of Unasur have been acting as a bloc in international fora such as the WHO and PAHO and presenting common positions at events as the United Nations high-level meeting on non-communicable chronic diseases and the World Conference on Social Determinants of Health, both held in 2011; and the Rio + 20 Conference in 2012. Isags, on the other hand, has supported the organization of workshops on governance as the one that gave rise to this book and, more recently, Workshops on Health Surveillance Governance, Health and the Environment in Sustainable Development and on Global Health and Health Diplomacy. These brief comments on the origin and development of Unasur Health and Isags ensure the dynamic progress of these initiatives. The demands generated at the Workshop on Health Systems have posed new challenges for their rating and would have to be addressed by the Council of Ministers and Isags. All these endeavors must be approached to ensure continuous improvement of governance in the social and health sectors, in particular, as an expression of the renewed democracy of the region. Rio de Janeiro, May 2012 Paulo M. Buss Director of the Center for International Relations of FIOCRUZ
  • 8. Presentation This book discloses a broad overview of health systems in the 12 nations that are part of the South American Health Council of Unasur. It describes the findings of the Opening Workshop of the South American Institute of Government in Health (Isags), “Health Systems in South America: challenges to the universality, integrality and equity” organized in Rio de Janeiro from July 26th to 29th , 2011. It originated in a proposal drafted by the Technical Group on Universal Health Systems of the Unasur Health Council that formulated the need of sharing a space for exchanging information related to the characteristics of health systems of the region that would also serve to unify criteria and discuss the challenges to providing health as a universal right, a concept that our countries consider as the main goal to guarantee the right to health. Isags took the responsibility to organize this workshop as its very first activity during the days following its formal opening on July 25th , 2011. The main purpose of the workshop was to foster the exchange of knowledge and a systematic and critical analysis of health systems in South America in the light of the challenges of universality, integrality and equity; identifying strengths and weaknesses that will make the process of defining cooperation lines and joint work easier. The preparation of the workshop started by developing a methodological guide which consisted of 11 dimensions to standardize the information that every country should deliver. This guide, developed by a group of experts, was discussed and validated in web conferences with the active and valuable participation of all the countries involved. Afterwards, the guide was sent to each country for data collection and preparation of the presentation to be delivered at the workshop; assessment was provided to the countries to help with the completion of the guide.
  • 9. 10 HEALTH SYSTEMS IN SOUTH AMERICA During the workshop, countries' representatives made a presentation on their health system with the aim of standardizing the information exchanged and providing full access to this information. It was decided that every country would prepare a broader explanatory document following the guide dimensions for publication. These documents make up the core of this publication which consists of 14 chapters and an Introduction based on the Opening Lecture of the workshop that underscores the challenges of universal health systems in the contemporary world. Chapter 1 provides a transversal analysis of health systems in South America and the challenges to structure universal health systems in the region. It is organized in two sections. In the first section relevant characteristics of health systems are summarized, analyzed and compared based on the dimensions selected from the facilitation guide such as the importance of health matters in the National Constitution, the structure of health systems, social protection, funding and health coverage arrangements in South American countries. In the second section, challenges to the universality, integrality and equity, including actions to be taken on social determinants of health, are examined. This analysis underlines the strengths common to all the countries and identifies weaknesses that require improvement in the region to accomplish universality with integrality and equity. The middle part of the book includes twelve chapters that analyze health systems of South American countries and documents developed by the Health Ministry of each country on the basis of the above mentioned guide composed of 11 dimensions, presented at the end of this book: 1. Social rights and health (legal bases and social participation) 2. Structure and organization of the health system (health system components, healthcare model, provision of healthcare services) 3. Current scenario in terms of universality, integrality and equity (models for population coverage, coverage of healthcare services, equity gaps) 4. Health system funding (sources of funding, public and private health expenditure) 5. Macromanagement (stewardship, policy formulation, powers of spheres of government and interinstitutional coordination, services and networks management models, healthcare services, and regulation of private health insurance and services) 6. Healthsurveillance(epidemiological,sanitaryandenvironmentalsurveillance) 7. Health workforce (gaps between the system demands and personnel supply, innovationsincontinuoustrainingandeducation,personnelmanagementmodels in healthcare, training and professional regulations, health workforce migration) 8. Action on social determinants of health (consistency between policies and action onsocialdeterminantsofhealth,intersectoralcoordinationstrategies,experiences developed, achievement of the Millenium Development Goals (MDGs)
  • 10. UNIVERSAL HEALTH SYSTEMS FOR A WORLD IN TRANSFORMATION 11 9. Strategic inputs to healthcare (policies on patents, investigation and innovation, price regulation, strategies for improving access to medication, national manufacturing capacities, dependence on foreign imports, evaluation for the incorporation and rational use of technology, use of Communication and Information Technology and telemedicine) 10. Research and innovation in health (national policies on health research, national institutes of health, gaps between research and system requirements) 11. Cooperation in health (strengths and weaknesses, technical support requirements, demand and potentialities) Chapter 14 summarizes the guidelines for cooperation in the building of universal health systems in the region on the basis of conclusions drawn at the workshop and proposals submitted by each country. Likewise, it seeks to identify cooperation needs and potential expertise in the areas mentioned by the countries in their national documents. We wish to express our gratitude and appreciation to all who contributed to the publicationofthiswork:theBrazilianMinistryofHealth,FiocruzInstituteandFiotec for providing funding, the Isags team for their effort in organizing the publication and in particular to all those who provided their support in the preparation of the country documents and made this publication possible. Congratulations to all the Ministers and Ministries that supported this significant initiative. Isags is proud to present this publication as a contribution to collective discussion, and to the construction and strengthening of our public health systems that are still facing significant challenges to universality, integrality and equity to guarantee the right to health of our people. This publication is the result of working together, sharing what we do and think, it is a tangible achievement: let’s use it to have a deeper understanding of each other, to find out what we are lacking and to grow stronger. Isags Board
  • 11. José Gomes Temporão1 The first point I wish to make when we think about health systems in South American countries is that these systems were historically created taking into account the disease rather than health as the core political category. Under the present historical conditions our countries are going through (Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Guyana, Paraguay, Peru, Surinam, Uruguay and Venezuela) the main focus when discussing the conception of health policies are social determinants of health. Why? Because all our systems were conceived on the basis of a biological model to control endemic diseases, through efforts that were, to a greater or lesser degree, fragmented. They were structured and based on medical knowledge centered on diseases as the reference parameter. At present, we all share the vision and the understanding that health is a socially determined political issue and that the development of the ideal health system that we all dream about should be based upon a deep and core discussion about social determinants of health. About how power and wealth are distributed in our societies, about the problem of inequities, about the need to radically develop democracy and about acting on the roots of production processes, about suffering and dying: the social determinants of health. The second point that should be underscored is that health systems are dynamic and hypercomplex structures. We can no longer think about health in our countries without considering the deep conjunctural and structural transformations our societies are experiencing in a variety of fields and dimensions reflected on their health systems. For didactic reasons we can call these transformations as the transition phenomenon in the field of public health. 1 Opening Conference of the workshop Sistemas de Salud de América del Sur: desafíos para la universalidad, integralidad y equidad, July 26th, 2011 – Inauguration of the South American Institute of Government in Health (ISAGS) Universal Health Systems for a World in Transformation
  • 12. 14 HEALTH SYSTEMS IN SOUTH AMERICA The first transition is demographic. The population in our continent is still predominantly young but we are experiencing a fast, continuous and sustained aging process. For example, it took France a whole century to reach the point that Brazil has reached in half of that time: fertility rate is dropping dramatically, life expectancy is lengthening, child mortality is diminishing, and the population is aging. These changes will cause a profound impact on our health systems because they are organized on structures designed to care for emergencies and acute conditions. Systems are not prepared to address the prevalence of chronic diseases, patients with multiple pathologies, metabolic syndrome; elderly patients who require different care, not necessarily medical, they rather need support, caretakers, nursing care. But the challenge of demographic transition is twofold: we will have to take better care of our future citizens, starting by planning the number of children and their development during childhood and follow them until old age. The second transition that is also linked to the demographic issue is the change in the epidemiological profile. We are following up the changes in the burden of diseases, morbidity and mortality profiles. Our continent has an additional aggravating factor because, apart from the increasing prevalence of chronic-degenerative diseases, there is still a significant burden of infectious- communicable diseases (double burden). The second aggravating factor and a significant one, is urban violence, homicide, interpersonal violence, a high traffic and occupational accident rates that complicate the epidemiological profile even further, a triple burden of disease in our countries. EstimatesoftheWorldHealthOrganization(WHO)revealthatinanearfuture one of the leading causes of morbidity will be senile dementia, neuropsychiatric disorders, depression and bipolar disorders. Our health systems are not prepared to address this new challenge. Even in Brazil, with a stronger health system, there is no adequate structure to provide care in these areas such as: family doctors, gerontologists, psychiatrists and psychologists. In spite of the fact that Brazil made a dramatic psychiatric reform it has yet not achieved an adequate structure to deal with this reality. Psychosocial care services are still insufficient. We have deinstitutionalized the mentally ill but have not achieved prevention. Our health systems must be prepared to deal with this new reality. The third fundamental transition that South American countries are going through is related to eating patterns. Strictly speaking, in Brazil we can no longer speak about famine or malnutrition but we cannot overlook the rise in juvenile obesity, a severe health problem. Changes in eating habits resulting from modifications in the family organization and structure in South American countries such as the rising number of women in the job market closely tied to
  • 13. UNIVERSAL HEALTH SYSTEMS FOR A WORLD IN TRANSFORMATION 15 profound changes in the industrialization of food production and the availability of ready or almost ready to eat meals will lead to the disruption of the traditional role of the person preparing food at home resulting in people increasingly eating out, consuming more industrialized food with high sodium, sugar and fat content. This is a new field within health regulation that also encompasses the advertising of food, beverages, fast food, etc. Recent data of the Brazilian Ministry of Health (Vigitel, 2011) reveal that 50% of the population in the country is considered to be overweight and 15% is obese. The forecasts of Type 2 Diabetes and hypertension epidemics in Brazil for the next decade depict a dramatic situation. The next dimension that requires consideration is the fourth transition, technology.Theincorporationoftechnologyinthemedicineofthefuture:biological drugs, robotics, nanodevices, therapeutic vaccines, and more personalized therapies. Genomics aims at the medicine of the future that will be predictive, personalized and preventive. Lately, adult human skin cells have been reprogrammed in induced pluripotent stem cells. But all of these possibilities are for the future. Reality is at present more dramatic. We live in a world divided into casts of citizens that either have access or not to modern technology. This scene appears once and again in every single one of our countries. The pharmaceutical industry is facing the dilemma of either having to launch new