Health Systems Global -
Regional Chapter for the Americas
Theme
"Future-oriented health systems in a changing world."
Health systems today operate amid persistent, intersectional disruptions, ranging from armed conflict and climate change to digital transformation, pandemics, and shifting geopolitical landscapes. These disruptors operate within a deeply inequitable ecosystem, where the implications of climate change, structural violence, gender inequalities, acute socioeconomic disparities, and legacies of discrimination have eroded health system performance, social equity, and public trust. They demand bold, forward-looking solutions that move beyond simply absorbing shocks to embrace adaptive leadership and system transformation.
The "Ninth World Symposium on Health Systems Research (HSR2026)" and the " Regional Pre-Conference for the Americas " position future-oriented transformation as the essential response, both for the health system and for the systems that impact health. This transformation focuses on the central question of "how": how to be more inclusive, responsive, and trustworthy. It is both a means and an end, requiring gradual and radical changes in how things work, how we collaborate, and how we perceive knowledge.
The theme of the events demands a solution-oriented commitment to the systemic reforms and strategic changes needed to build equitable, inclusive, resilient, responsive, and trustworthy health systems. It invites reflection on how health systems can learn, transform, and lead. Crucially, as the world moves toward the post-SDG era and future global health initiatives, architectures, and frameworks remain uncertain, HSG provides a space to reflect on unfinished agendas and forge a shared vision for a transforming world, rooted in solidarity, social justice, and systemic change at all levels, from communities to the global health architecture.
These events will bring together established and emerging leaders whose work involves and impacts health systems: scientists, academics, service providers, and politicians, to co-create viable pathways for our future shared and interdependent health systems.
The Symposium's theme will encompass four sub-themes, detailed below. Each sub-theme allows for independent, yet interconnected, reflection on how to understand, envision, design, negotiate, and implement the transformation of health systems with a forward-looking vision.
Sub-topic 1. Politics and Polycrisis
Governance, financing and diplomacy in the face of conflicts and the changing global order.
Political structures, power dynamics, and governance mechanisms, both nationally and globally, shape the functioning, reform, and outcomes of health systems. Today, many systems operate under conditions of fragile governance, challenged legitimacy, and eroding public trust—conditions that seriously jeopardize their ability to function effectively, equitably, and sustainably.
In contexts of war and conflict, health systems face not only physical threats to infrastructure and personnel, but also structural political challenges, ranging from the fragmentation of authority to the politicization of aid. Healthcare workers, facilities, and access to healthcare are increasingly politicized, instrumentalized, or undermined by attacks on neutrality and questioned governance. Addressing health in these contexts often involves grappling with war, displacement, occupation, and the instrumentalization of aid.
Meanwhile, global health financing is becoming increasingly volatile and fragmented. Traditional donor funding is shrinking, the influence of private and philanthropic actors is growing, and financial flows often fail to align with national priorities. These dynamics are exacerbated by political polarization in many countries across all income levels, undermining health leadership, disrupting coordination, and eroding public trust. This directly impacts the ability of health systems to plan, coordinate, and maintain equitable health service delivery and further exacerbates limited domestic investment in health systems. Many countries remain heavily reliant on external aid, leading to calls for increased domestic health financing and ongoing debates about the appropriate timing and capacity to withdraw foreign assistance.
The weakening of multilateralism and the rise in geopolitical tensions pose an additional challenge to global health governance. In this fragmented landscape, new forms of diplomacy and governance are urgently needed to help address transnational threats while building public trust and strengthening national and regional sovereignty.
This subtopic:
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Explore how governance, financing, and political leadership at the national and global levels can evolve to address complexity, protect health and health systems in crisis situations, and strengthen public legitimacy and trust.
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It encourages bold reflection on how to reimagine leadership and solidarity in health for a fairer and more sustainable future beyond 2030.
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Welcome proposals on political innovation, governance reform and diplomacy based on real struggles and strategies for communities, civil society organizations, professionals, advocates, decision-makers, research institutions or negotiation tables.
Sub-topic 2. Plurality and Partnerships
Incorporating the diversity of actors, sectors, and care modalities.
Current health systems are diverse, plural, and often fragmented, encompassing public and private actors, formal and informal sectors, and traditional and allopathic medicine systems. This sub-topic explores how incorporating this plurality of actors, sectors, and care modalities can strengthen the performance, responsiveness, inclusion, and equity of health systems.
Plurality operates in at least two critical dimensions. First, in terms of actors and sectors, health systems extend beyond ministries of health and hospitals; they are comprised of frontline workers, community organizers, civil society, religious leaders, technology companies, food and beverage retailers, social media influencers, educators, environmental planners, and peace advocates. Meaningful engagement with this broad spectrum of actors is vital for transforming systems into inclusive, equitable, and responsive ones to complex challenges.
This subtopic challenges technocratic and compartmentalized approaches and calls for new collaborative frameworks that connect sectors, redistribute power, and promote accountability.
Secondly, plurality encompasses care modalities and points of access to the system. People interact with health systems through a wide range of practices, including biomedical care, traditional and complementary medicine, and self-care rooted in local knowledge and cultural systems. These approaches are often essential, especially in low-resource settings, but are frequently overlooked in policies, metrics, and investment. This subtopic highlights how unmet needs, neglected care, and marginalized populations expose the limitations of conventional system design and measurement.
This subtopic:
Examines the effects of privatization, the growing role of non-state actors, and the resulting changes in the organization and governance of health systems, access to healthcare, and equity.
Emphasizes the need for multisectoral strategies and systems thinking to address the broader social and commercial determinants of health in the areas of education, food, labor, the environment, and technology.
Sub-topic 3. Platforms and Participation
Leveraging digital technologies while respecting social contracts.
Platforms are the structural foundations that underpin modern health systems, encompassing physical infrastructure (such as hospitals and primary care networks), digital technologies, institutional frameworks, and the social contracts that link communities, governments, and health sector actors. This subtopic explores how these platforms shape the performance and resilience of health systems, inclusion, and equitable access to healthcare.
Digital technologies and artificial intelligence (AI) are rapidly transforming healthcare systems, from service delivery and logistics to health information systems, real-time surveillance, and decision support. AI is also transforming health policy and systems research, offering new tools for modeling, forecasting, and systems design.
While these digital innovations offer effective ways to strengthen access and responsiveness, they also carry risks of exclusion, bias, data privacy issues, and loss of public trust if not managed responsibly.
At the same time, the proliferation of digital platforms contributes to the increase in rates of overexposure and digital harm, with consequences for mental and physical health.
Meanwhile, traditional service platforms, such as hospitals and primary care networks, are also facing demands for integration, flexibility, and a people-centered approach. Their ability to coordinate across sectors, absorb shocks, and adapt to new roles is becoming increasingly crucial.
These changes also draw attention to the often-overlooked infrastructure of social contracts: the implicit and explicit agreements between individuals, institutions, and states regarding shared responsibility, care, and accountability. Revitalizing and renegotiating these contracts is essential to ensuring that systems remain inclusive, responsive, accountable, and trustworthy.
This subtopic:
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It emphasizes the need to promote smart health systems and to govern platforms (including AI and data systems), not only as technical tools, but also as political, ethical, value-based and social infrastructures that should reflect the values, norms and rules of the societies they serve.
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Welcome proposals that examine how platforms — digital, physical and social — can be designed, governed and leveraged to drive equity, participation and transformation in health systems.
Sub-topic 4. Paths and Planet
Human-ecological concerns in a post-SDG era
The comprehensive transformation of health systems requires addressing the realities of our planetary condition. Health systems face growing threats stemming from the climate crisis, emerging infectious diseases, and the complex interconnections between human, animal, and environmental health.
Climate change is driving extreme weather events, as well as indirect consequences such as food insecurity, evolving disease patterns, and increased mental health problems. All of this disproportionately affects vulnerable and marginalized populations. Many countries struggle to integrate climate risks into health policies and practices, and urgent action is needed to integrate climate resilience into health governance, financing, and infrastructure.
Infectious diseases, both emerging and re-emerging, are exacerbated by climate change, urbanization, and environmental degradation. Many health systems continue to rely on fragmented, disease-specific programs, lacking essential capacities in surveillance, risk communication, and supply chain resilience. Adaptive and responsive systems require a long-term vision for strengthening health systems within a broader framework of justice and ecological balance, rather than reactive responses to emergencies.
The One Health approach, which recognizes the intrinsic links between human, animal, and environmental health, provides a vital framework for addressing zoonotic impacts, vector-borne diseases, and antimicrobial resistance. However, the implementation of One Health is hampered by institutional fragmentation, fragmented funding, and a lack of coordinated policies and implementation frameworks.
Therefore, strengthening integrated surveillance and data systems, a trained multisectoral workforce, and intersectoral coordination are essential to building resilient and equitable health systems.
This subtopic:
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Analyze the future of sustainable and planetary health systems, based on justice and solidarity between species.
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Explore how systems can become climate-resilient, justice-centered, and sustainable.
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It also calls for bold reflection on what the post-SDG future might look like.
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It welcomes proposals that explore innovative policies, governance mechanisms, and community actions to improve the capacity to respond to climate change, while redefining what a successful performance transformation looks like.