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Objetivo: compreender a participação da IA nos diagnósticos da saúde moderna e definir limites para sua aplicação. Metodologia: Revisão integrativa da literatura. A busca dos estudos se deu nas bases de dados LILACS, MEDLINE e SCIELO e foram selecionados artigos científicos, sem recorte temporal e de idioma. Resultados: A inteligência artificial impacta a medicina em três níveis: otimiza a interpretação de imagens para os médicos, aprimora o fluxo de trabalho reduzindo potenciais erros para os sistemas de saúde e capacita os pacientes a processarem seus próprios dados para promover a saúde. Contudo, é necessária atenção aos dados gerados, pois podem desencadear erros em cascata e expor informações sensíveis dos usuários do sistema de saúde. Conclusão: Atribuir à IA a responsabilidade de escolhas e funções desempenhadas por humanos é intrinsecamente perigoso, apesar de sua contribuição inegável nos processos diagnósticos. Sugere-se a realização de pesquisas robustas para compreender plenamente o impacto dessa nova era tecnológica proporcionada pela IA na área da saúde.

Objective: To understand the role of AI in modern healthcare diagnostics and define boundaries for its application. Methodology:Integrative literature review. Studies were searched in the LILACS, MEDLINE, and SCIELO databases, selecting scientific articles without temporal or language restrictions. Results: Artificial intelligence impacts medicine at three levels: it optimizes image interpretation for physicians, enhances workflow by reducing potential errors for healthcare systems, and empowers patients to process their own data to promote health. However, attention is required regarding the generated data, as it may trigger cascading errors and expose sensitive information of healthcare system users. Conclusion: Assigning AI, the responsibility of choices and functions performed by humans is inherently dangerous, despite its undeniable contribution to diagnostic processes. Robust research is suggested to fully understand the impact of this new technological era provided by AI in healthcare.

Objetivo: Comprender la participación de la IA en los diagnósticos de la salud moderna y definir límites para su aplicación. Metodología:Revisión integrativa de la literatura. Los estudios se buscaron en las bases de datos LILACS, MEDLINE y SCIELO, seleccionando artículos científicos sin restricciones temporales ni lingüísticas. Resultados: La inteligencia artificial impacta la medicina en tres niveles: optimiza la interpretación de imágenes para los médicos, mejora el flujo de trabajo al reducir errores potenciales para los sistemas de salud y capacita a los pacientes para procesar sus propios datos y promover la salud. Sin embargo, se requiere atención respecto a los datos generados, ya que pueden desencadenar errores en cascada y exponer información sensible de los usuarios del sistema de salud. Conclusión: Asignar a la IA la responsabilidad de decisiones y funciones realizadas por humanos es intrínsecamente peligroso, apesar de su contribución innegable a los procesos de diagnóstico. Se sugiere realizar investigaciones sólidas para comprender completamente el impacto de esta nueva era tecnológica proporcionada por la IA en la salud.

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Objetivos: analisar se a Recomendação Geral n.º24, sobre saúde da mulher, amplia ou constrói interpretações para os Estados Partes da Convenção para a Eliminação de todas as Formas de Discriminação contra a Mulher. Metodologia: foi realizada uma pesquisa documental e bibliográfica para coletar dados e revisar criticamente documentos internacionais e literatura especializada. Os resultados foram analisados por meio da revisão crítico-narrativa. Resultados: a Convenção abrange direitos da mulher, incluindo saúde, e o Comitê da Convenção sobre a eliminação de todas as formas de discriminação contra as mulheres emite recomendações gerais para orientar sua implementação pelos Estados Partes. A Recomendação Geraln.º24 amplia as recomendações originais, abordando questões como saúde sexual, violência de gênero e participação na tomada de decisões. Conclusões: a interpretação política da Convenção, conforme preconizado por Kelsen, permite observar as necessidades e o contexto político dos Estados-parte. A Recomendação Geraln.º24 amplia as recomendações, refletindo a necessidade de adaptação das políticas públicas às mudanças globais e às necessidades das mulheres.

Objectives: This study examines whether General Recommendation (GR) No. 24, on women's health, broadens or constructs interpretations for the State parties of the Convention on the Elimination of All Forms of Discrimination against Women. Methodology: A documentary and bibliographical research was conducted to collect data and critically review international documents and specialized literature. The results were analyzed through critical-narrative review. Results: The Convention covers women's rights, including health, and the Committee on the Elimination of Discrimination against Women issues general recommendations to guide its implementation by State parties. GR No. 24 expands the original recommendations, addressing issues such as sexual health, gender-based violence, and participation in decision-making. Conclusions: The political interpretation of the Convention, as advocated by Kelsen, enables the observation of the needs and political context of the State parties. GR No. 24 expands the recommendations, reflecting the need to adapt public policies to global changes and women's needs.

Objetivos: Este estudio analiza si la Recomendación General (RG) n. 24, sobre la salud de la mujer, amplía o construye interpretaciones para los Estados Partes de la Convención para la Eliminación de todas las Formas de Discriminación contra la Mujer. Metodología: Se realizó una investigación documental y bibliográfica para recopilar datos y revisar críticamente documentos internacionales y literatura especializada. Los resultados fueron analizados mediante la revisión crítico-narrativa. Resultados: La Convención abarca los derechos de las mujeres, incluida la salud, y el Comité de la Convención sobre la eliminación de todas las formas de discriminación contra la mujer emite recomendaciones generales para guiar su implementación por parte de los Estados-partes. La RG n. 24 amplía las recomendaciones originales, abordando cuestiones como la salud sexual, la violencia de género y la participación en la toma de decisiones. Conclusiones: La interpretación política de la Convención, como preconiza Kelsen, permite la observación de las necesidades y el contexto político de los Estados Partes. La RG n. 24 amplía las recomendaciones, reflejando la necesidad de adaptar las políticas públicas a los cambios globales y a las necesidades de las mujeres.

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Resumo As Emergências em Saúde Pública (ESP) têm repercutido nos sistemas de saúde em escala global. O acesso às novas tecnologias em saúde em tempo oportuno é um desafio para a política de saúde. As autoridades reguladoras nacionais (ARN) têm papel fundamental na avaliação e regulação dessas tecnologias. O estudo objetiva analisar as principais estratégias e instrumentos regulatórios utilizados para lidar com os desafios da regulação de novas tecnologias necessárias à resposta do sistema de saúde durante as ESP. Trata-se de uma pesquisa normativa e documental, tendo como fonte a OMS e a ARN brasileira. Foram consideradas as dimensões relacionadas às estratégias para o fortalecimento das atividades regulatórias e os instrumentos regulatórios utilizados para acelerar o acesso às tecnologias, especialmente durante as ESP. A cooperação e a colaboração internacional entre as ARN e com a OMS foram importantes estratégias para o fortalecimento das ARN, com destaque para o uso de confiança, regionalização, avaliações aceleradas e compartilhamento de trabalho/informações, bem como os processos de harmonização e convergência regulatória. Identificou-se, além da utilização de instrumentos regulatórios já existentes, esforços na implementação de novos, com destaque para Autorização de Uso Emergencial.

Abstract Public Health Emergencies (PHE) have had repercussions on health systems on a global scale, and timely access to new health technologies is a challenge for health policy. The national regulatory authorities (NRA) play a key role in the evaluation and regulation of these technologies. The present study aims to analyze the main strategies and regulatory instruments used to deal with the challenges of regulating new technologies necessary for the health system's effective response during a PHE. This research, based on WHO and Brazilian NRA norms and documents, considered dimensions related to strategies for strengthening regulatory activities and regulatory instruments used to accelerate access to technologies, especially during PHEs. International cooperation between the NRA and the WHO were important strategies for strengthening the NRA, with emphasis on the use of reliance, regionalization, accelerated assessments, and work/information sharing, as well as the processes of regulatory harmonization and convergence. In addition to the use of existing regulatory instruments, efforts were also identified in order to implement new ones.

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Resumo O Fórum para a Cooperação Econômica e Comercial entre a China e os Países de Língua Portuguesa, mais conhecido como Fórum de Macau, fundado em 2003, atua há 20 anos como elo entre a China e os países lusófonos. Desde 2016, o Secretariado Permanente do Fórum de Macau publica um anuário destacando as principais atividades realizadas pelo mesmo no ano anterior. Este artigo tem como foco analisar o papel do Fórum de Macau como organizador e mediador de iniciativas de Saúde Global através da análise de todos os artigos publicados em seus anuários entre 2016 e 2023. Foram encontradas 34 ocorrências de artigos tratando de algum tema relacionado à área da saúde, com quase dois terços relacionados à medicina tradicional chinesa, relatos de organização frequente de atividades que fomentam a cooperação internacional em saúde, além de uma ativa participação durante o primeiro ano da pandemia de Covid-19. O Fórum de Macau é uma plataforma multilateral de diálogo entre a China, Macau e o mundo de fala portuguesa, tendo a pauta da saúde e a divulgação da medicina tradicional chinesa ocupado um espaço de destaque em seu anuário.

Abstract The Forum for Economic and Trade Cooperation between China and Portuguese-speaking Countries, better known as Forum Macao, founded in 2003, has been acting as a link between China and Portuguese-speaking countries for 20 years. Since 2016, the Permanent Secretariat of Forum Macao has published a yearbook highlighting the main activities it carried out in the previous year. This article focuses on analyzing Forum Macao's role as an organizer and mediator of Global Health initiatives by analyzing all the articles published in its yearbooks between 2016 and 2023. We found 34 articles dealing with a health-related topic, with almost two thirds related to traditional Chinese medicine, reports of frequent organization of activities that foster international cooperation in health, as well as active participation during the first year of the Covid-19 pandemic. Forum Macao is a multilateral platform for dialogue between China, Macao and the Portuguese-speaking world, with the health agenda and the dissemination of traditional Chinese medicine occupying a prominent place in its yearbook.

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Introducción: La necesidad de información por desconocimiento del Sars-CoV-2 llevó a los investigadores a generar una gran cantidad de información. Colombia es el segundo país latinoamericano con mayor producción científica sobre el Sars- CoV-2. Objetivo: caracterizar la tendencia de colaboración científica de Colombia con países de Latinoamérica y el Caribe sobre la COVID-19. Materiales y métodos: estudio bibliométrico, los registros se obtuvieron de Scopus (2020 - 2021) con los términos COVID-19, 2019-nCoV, new coronavirus, coronavirus disease 2019 y Sars-CoV-2. Se analizaron indicadores de producción, colaboración y visibilidad. Resultados: se recuperaron 77 registros. La tasa de crecimiento de la producción fue del 65,51 %. El índice de transitoriedad alcanzó el 86,69 %. El autor más productivo fue A.J. Rodríguez Morales de la Fundación Universitaria Autónoma de las Américas y Universidad Tecnológica de Pereira de Colombia (14,28 %). El 96,10 % de las investigaciones procedieron de universidades. La tasa de colaboración inter-latinoamericana alcanzó el 11,66 % con un índice de colaboración de 3,71 ± 3,09. La densidad de la red fue de 0,51. La mayor colaboración se dio con autores de México (n= 27), Perú (n= 26), Chile (n= 25) y Argentina (n= 23). Argentina presentó un mayor outdegree (176) y número de citas (55,03) y Chile un eigenvector superior (0,35). La correlación entre el número de citas y el grado de centralidad fue de 0,9. Conclusión: Colombia tiende a participar en proyectos internacionales y con países de Latinoamérica y el Caribecon mayor capacidad para desarrollar investigaciones.

Introduction: The need for information due to ignorance of Sars-CoV-2 led researchers to write and publish a large amount of information. Colombia is the second within Latin American countries with the highest scientific production on Sars- CoV-2. Objective: to characterize the trend of scientific collaboration between Colombia and Latin American and Caribbean countries on COVID-19. Materials and methods: bibliometric study, the records were acquired from Scopus (2020 - 2021) with the terms COVID-19, 2019-nCoV, new coronavirus, coronavirus disease 2019 and Sars-CoV-2. Indicators of production, collaboration and visibility were analyzed. Results: 77 records were recovered. The production growth rate was 65.51%. The transience index reached 86.69%. The most productive author was A.J. Rodríguez Morales of the Autonomous University Foundation of the Americas and the Technological University of Pereira of Colombia (14.28%). 96.10% of the investigations came from universities. The inter-Latin American collaboration rate reached 11.66% with a collaboration index of 3.71 ± 3.09. The density of the network was 0.51. The greatest collaboration occurred with authors from Mexico (n= 27), Peru (n= 26), Chile (n= 25) and Argentina (n= 23). Argentina presented a higher degree of improvement (176) and number of citations (55.03) and Chile a higher eigenvector (0.35). The connection between the number of citations and the degree of centrality was 0.9. Conclusion: Colombia tends to participate in international projects and with Latin America and the Caribbeancountries with greater capacity to develop research.

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Background: International and market forces are key drivers of deforestation and forest degradation, with transnational and market-based solutions in land-use and forest governance often missing economic, distributive, and environmental targets. Methods: This paper tackles both the framing and effectiveness of transnational initiatives affecting forest lands and peoples in the Global South, and the quality of relationships between institutions in the Global North and the Global South. Through more equitable research partnerships, this paper draws lessons from case studies in Indonesia (legality verification system in different forest property regimes), the Democratic Republic of the Congo (lifting of a moratorium on new logging concession), and Brazil (FSC in the Amazon region and the Amazon Fund). Results: International partnerships have privileged market-based instruments and commodity exchange between Global South and Global North countries, and the benefits of such mechanisms are unevenly distributed. Complementary and alternative policy instruments are discussed for each geography. Conclusions: Glocalizing land-use and forest governance implies in advancing equitable research partnerships between institutions in the Global South and Global North, and strengthening a community of practice for critical enquiry and engagement in partnerships for sustainable development. Land-use, climate and forest governance mechanisms must redress power dynamics, and partnership models, and commit to improving well-being and sustainable livelihood outcomes.

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R E S U M E N El artículo tiene por objetivo el analizar la cooperación internacional, desde el convenio entre la Universidad de Atacama UDA-Chile y la Universidad de Nariño UDENAR-Colombia, las dos instituciones son de educación superior públicas y regionales. El estudio fue cualitativo - descriptivo, los participantes fueron I3 entre docentes, administrativos y estudiantes pertenecientes a las dos universidades. Sus edades fluctúan entre los 21 y 59 años, hombres y mujeres, nacidos en Chile o Colombia. Se utilizó como técnicas de recolección de información el análisis documental y un cuestionario con preguntas abiertas. Los resultados muestran una valoración positiva del convenio puesto que se ha manejado desde las tres funciones sustantivas universitarias: docencia, investigación e interacción social; en este mismo sentido se hace fuerte los aprendizajes adquiridos por cada participante y la necesidad de profundizar en investigación. Se concluye que la internacionalización tiene muchos beneficios desde el intercambio cultural, el prestigio internacional y los aprendizajes, así como la transdisiciplinariedad del convenio, que a través del pensamiento crítico construyendo espacios de diálogo de saberes no fragmentado en disciplinas, sino unido por un interés genuino por el conocimiento.

The article aims to analyze international cooperation, from the agreement between the University of Atacama UDA-Chile and the University of Nariño UDENAR-Colombia, the two institutions are public and regional higher education. The study was qualitative - descriptive, the participants were I3 among teachers, administrators and students belonging to the two universities. Their ages fluctuate between 21 and 59 years, men and women, born in Chile or Colombia. Documentary analysis and a questionnaire with open questions were adapted as data collection techniques. The results show a positive assessment of the agreement since it has been managed from the three substantive university functions: teaching, research and social interaction; In it, the learning acquired by each participant and the need to deepen the investigation become strong. It is concluded that internationalization has many benefits from cultural exchange, international prestige and learning, as well as the transdisciplinarity of the agreement, which through critical thinking, building spaces for dialogue of knowledge not fragmented into disciplines, but united by genuine interest for knowledge.

O artigo tem como objetivo analisar a cooperação internacional, a partir do convênio entre a Universidade de Atacama UDA-Chile e a Universidade de Nariño UDENAR-Colômbia, as duas instituições são públicas e de ensino superior regional. O estudo foi qualitativo - descritivo, os participantes foram I3 entre professores, administradores e alunos pertencentes às duas universidades. Suas idades oscilam entre 2I e 59 anos, homens e mulheres, nascidos no Chile ou na Colômbia. A análise documental e um questionário com questões abertas foram utilizados como técnicas de coleta de dados. Os resultados mostram uma avaliação positiva do convênio, uma vez que tem sido gerido a partir das três funções substantivas da universidade: ensino, pesquisa e interação social; Nesse mesmo sentido, torna-se forte o aprendizado adquirido por cada participante e a necessidade de aprofundar a pesquisa. Conclui-se que a internacionalização traz muitos benefícios pelo intercâmbio cultural, prestígio internacional e aprendizado, bem como a transdisciplinaridade do convênio, que por meio do pensamento crítico, constrói espaços de diálogo de saberes não fragmentados em disciplinas, mas unidos pelo interesse genuíno.

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Leishmaniasis is an infectious disease that belongs to the top 10 neglected tropical diseases. It mainly affects the poor population from tropical and subtropical areas of the World, which lacks sufficient resources and means to fight against this disease. With this in mind, the European Commission has funded an international collaborative research project in which are participating various institutions from South America, North Africa and Europe. The main objective of this project is the development of a fast, less expensive, non-invasive and easy to use alternative method for leishmaniasis diagnosis in dogs, one of the main reservoirs of leishmaniasis spread to humans. In this perspective article, we present our personal insight and opinion regarding the challenges of realizing a joint international research project on leishmaniasis in Colombia, a country where leishmaniasis is endemic, as well as regarding the involvement of the Public Health institutions and the local population from this country.

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This article discusses the role of the epistemic community linked to the training of health technicians through analysis of the actions initiated by the Pan-American Health Organization/World Health Organization (PAHO/WHO) Collaborating Center for the education of these technicians during the COVID-19 pandemic, with the aim of comparing these actions with the main elements that define the constitution and functioning of epistemic communities according to the specialized literature. It is argued that, despite the differences in the historical configuration of national healthcare and training systems, the emergence of common challenges in the training of technicians allowed the articulation of demands, the sharing of diagnostic assessments, and the cooperation between the International Network of Health Technicians Education, the Ibero-American Network of Health Technicians Education, and the Community of Portuguese Language Countries Network of Health Technician Schools, promoting the exchange of experiences, the search for strategic solutions, and the dissemination of recommendations across countries. By reaffirming the central role of health technicians in epidemiological surveillance, diagnosis and assistance, the COVID health emergency demanded immediate and consistent responses from governments and educational institutions, favoring the strengthening of the health technician epistemic community through the circulation of discourses and the hegemonization of meanings for the education of technicians. These actions, however, do not translate into stability or homogeneity for the epistemic community, since their articulation is always provisional and contingent, nor do they ensure the capacity to directly influence policies in each country.

En este artículo se examina el desempeño de la comunidad epistémica vinculada a la educación de técnicos en salud a partir del análisis de las medidas iniciadas por el centro colaborador de la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS) para la educación de técnicos en salud durante la pandemia de COVID-19, con el objetivo de comparar estas medidas con los principales elementos que definen la constitución y el funcionamiento de las comunidades epistémicas, de conformidad con la bibliografía especializada. Se argumenta que, a pesar de las diferencias en la configuración histórica de los sistemas nacionales de salud y de educación, el surgimiento de desafíos comunes para la educación de técnicos propició la articulación de demandas, el intercambio de evaluaciones con fines de diagnóstico y la cooperación entre la Red Internacional de Educación de Técnicos en Salud, la Red Iberoamericana de Educación de Técnicos en Salud y la Red de Escuelas Técnicas de Salud de la Comunidad de Países de Lengua Portuguesa, con el fin de promover el intercambio de experiencias, la búsqueda de soluciones estratégicas y la difusión de recomendaciones entre los países. Al reafirmar el papel central de los técnicos en las medidas de vigilancia epidemiológica, diagnóstico y atención, la emergencia de salud exigió respuestas inmediatas y coherentes de los gobiernos y de las instituciones educativas, lo cual favoreció el fortalecimiento de la comunidad epistémica vinculada a la educación de técnicos en salud al hacer circular discursos y ejercer hegemonía con respecto al sentido de la educación de esos profesionales. Sin embargo, esta actuación no confiere estabilidad ni homogeneidad a dicha comunidad epistémica, en vista de que sus afirmaciones son provisionales y contingentes, ni asegura su capacidad de influir directamente en las políticas de cada país.

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Introducción: Cuba se ha caracterizado por enviar a diversos países delegaciones de salud, llamadas "misiones médicas". Sin embargo, el interés de los futuros profesionales de formar parte de esas delegaciones no se ha investigado. Objetivos: Caracterizar la disposición hacia la colaboración médica internacional e identificar los factores asociados en estudiantes cubanos de Estomatología. Métodos: Se realizó una investigación transversal, analítica de datos secundarios, en estudiantes de todos los años del curso académico 2018-2019, pertenecientes a ocho universidades. La variable dependiente fue el reporte de la disposición de ir a misiones médicas. Se calcularon las razones de prevalencia e intervalos de confianza al 95 por ciento. Resultados: Participaron 1174 estudiantes, de los cuales 830 (71 por ciento) estuvieron dispuestos a cumplir misiones médicas. Existió una mayor disposición hacia la colaboración médica conforme aumentaba la edad (RPa: 1,02; IC 95 por ciento: 1,00-1,04; p = 0,044); así como, en los estudiantes que reportaron presión familiar para estudiar la carrera (RPa: 1,17; IC 95 por ciento: 1,09-1,26; p < 0,001). Aquellos que reportaron buenas notas antes de ingresar a la universidad (RPa: 0,83; IC 95 por ciento: 0,77-0,91; p < 0,001), los de solvencia económica (RPa: 0,90; IC 95 por ciento: 0,90-0,98; p = 0,019) y los que estaban cursando el tercer y cuarto años académicos (RPa: 0,93; IC 95 por ciento: 0,88-0,97; p = 0,003) fueron los de menor disposición para colaborar; ajustado por el sexo y la universidad. Conclusión: Existe una elevada disposición hacia la colaboración médica internacional y está asociada a múltiples aspectos sociales y educativos(AU)

Introduction: Cuba has been characterized by sending health delegations to various countries, called "medical missions". However, the interest of future professionals in joining those delegations has not been investigated. Objectives: Characterize the disposition towards international medical collaboration and identify the associated factors in Cuban students of Stomatology. Methods: A cross-sectional research and secondary data analytics was carried out in students of all years of the academic year 2018-2019, belonging to eight universities. The dependent variable was the report of the willingness to go on medical missions. Prevalence ratios and 95 percent confidence intervals were calculated. Results: 1174 students participated, of which 830 (71 percent) were willing to fulfill medical missions. There was a greater willingness towards medical collaboration as age increased (RPa: 1.02; 95 percent CI 1.00-1.04; p = 0.044); as well as, in students who reported family pressure to study the career (RPa: 1.17; 95 percent CI 1.09-1.26; p < 0.001). Those who reported good grades before entering college (RPa: 0.83; 95 percent CI 0.77-0.91; p < 0.001), those of economic solvency (RPa: 0.90; 95 percent CI 0.90-0.98; p = 0.019) and those who were in the third and fourth academic years (RPa: 0.93; 95 percent CI 0.88-0.97; p = 0.003) were those with the least willingness to collaborate; adjusted by sex and college. Conclusion: There is a high disposition towards international medical collaboration and it is associated with multiple social and educational aspects(AU)

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RESUMO Este artigo analisa como a saúde entrou na política externa brasileira entre 1995 e 2010 e apoiou a posição internacional do País, utilizando o enfoque de análise de políticas. Essa questão raramente é examinada na literatura brasileira sobre diplomacia da saúde. A partir de revisão de literatura, análise documental e entrevistas com atores-chave, examinamos as políticas impulsionadas por complexos processos históricos de mudança no Brasil. Há importantes inter-relações entre política externa e política social, incluindo saúde. Durante os governos Lula (2003-2010), a internacionalização das políticas domésticas brasileiras, vinculadas à cooperação Sul-Sul, teve papel central. A saúde na agenda da política externa foi um importante suporte à crescente presença internacional do Brasil. Esses desenvolvimentos foram possibilitados pelo ativismo e comprometimento de diversos atores estatais e não estatais, que atuaram em dois níveis: advocacia nacional e transnacional e atividades coordenadas entre representantes do governo, incluindo diplomatas, e atores da sociedade civil. O principal argumento deste estudo é que as políticas nacionais e internacionais são interrelacionadas nesse processo, e a dinâmica doméstica e o engajamento societal são essenciais, mas não suficientes: escolhas governamentais são também determinantes. Os arranjos institucionais e políticos mudaram em diferentes conjunturas e são constantemente propensos a conflitos e mudanças.

ABSTRACT This article analyses, from a policy analysis approach, how health entered Brazilian foreign policy between 1995 and 2010 and supported the country's international position, which is rarely explored in the literature on Brazilian health diplomacy. By drawing on literature review, document analysis and key-actor interviews, we examined policies triggered by far-reaching and complex historical change processes in Brazil. We find significant interrelationships between foreign policy and social policy, including health. The internationalization of Brazilian domestic policies, and South-South cooperation, played a central role during Lula governments (2003-2010). Health found its way into the foreign policy agenda to support Brazil's growing international presence. These developments were made possible by the activism and engagement of several of State and non-State actors working on two levels: national and transnational advocacy, and coordinated activities of government representatives, including Brazilian diplomats, and civil society activists. The main argument of this study is that national and international policies are intertwined in this process and that domestic dynamics and societal engagement are essential but more is needed: governmental choices are also determinant. Institutional arrangements and policies shift in different conjunctures and are constantly prone to conflicts and change.

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Resumo O objetivo deste artigo foi identificar os principais desafios da promoção da vigilância em saúde em uma região de tríplice fronteira da Amazônia Legal brasileira. Foi realizado um estudo de caso único, explicativo, com abordagem qualitativa, que utilizou dados documentais e entrevistas. Os resultados demonstram que a vigilância em saúde é fundamental para o controle de doenças na região. Além disso, as diferenças dos sistemas de saúde dos três países que compõem a tríplice fronteira (Brasil, Colômbia e Peru) se mostraram o principal desafio para o estabelecimento de políticas sanitárias.

Abstract The objective of This article was to identify the main challenges of promoting health surveillance in a triple border region of the Brazilian legal Amazon. A single explanatory case study was carried out, with a qualitative approach, which used documentary data and interviews. The Results demonstrate that health surveillance is essential for disease control in the studied region. In addition, the differences between the health systems of the three countries that make up the triple border (Brazil, Colombia, and Peru) showed to be the main challenge for establishing health policies.

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RESUMO Este artigo discute a atuação da comunidade epistêmica ligada à formação de técnicos em saúde a partir da análise das ações desencadeadas pelo Centro Colaborador da Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS) para a educação desses técnicos durante a pandemia de covid-19, com o objetivo de cotejar essas ações com os principais elementos que definem a constituição e o funcionamento de comunidades epistêmicas conforme a literatura especializada. Argumenta-se que, a despeito das diferenças na configuração histórica dos sistemas nacionais de saúde e dos sistemas formadores, o surgimento de desafios comuns na formação de técnicos propiciou articulação de demandas, compartilhamento de avaliações diagnósticas e cooperação entre a Rede Internacional de Educação de Técnicos em Saúde, a Rede Ibero-Americana de Educação de Técnicos em Saúde e a Rede de Escolas Técnicas de Saúde da Comunidade dos Países de Língua Portuguesa, promovendo troca de experiências, busca de soluções estratégicas e disseminação de recomendações entre os países. Ao reafirmar o papel central dos técnicos nas ações de vigilância epidemiológica, diagnóstico e assistência, a emergência sanitária exigiu respostas imediatas e consistentes de governos e instituições formadoras, favorecendo o fortalecimento da comunidade epistêmica de formação de técnicos em saúde pela circulação de discursos e da hegemonização de sentidos para a educação de técnicos em saúde. Essa atuação, no entanto, não confere estabilidade ou homogeneidade à comunidade epistêmica de formação de técnicos em saúde, uma vez que suas articulações são provisórias e contingentes, nem assegura capacidade de influência direta sobre as políticas em cada país.

ABSTRACT This article discusses the role of the epistemic community linked to the training of health technicians through analysis of the actions initiated by the Pan-American Health Organization/World Health Organization (PAHO/WHO) Collaborating Center for the education of these technicians during the COVID-19 pandemic, with the aim of comparing these actions with the main elements that define the constitution and functioning of epistemic communities according to the specialized literature. It is argued that, despite the differences in the historical configuration of national healthcare and training systems, the emergence of common challenges in the training of technicians allowed the articulation of demands, the sharing of diagnostic assessments, and the cooperation between the International Network of Health Technicians Education, the Ibero-American Network of Health Technicians Education, and the Community of Portuguese Language Countries Network of Health Technician Schools, promoting the exchange of experiences, the search for strategic solutions, and the dissemination of recommendations across countries. By reaffirming the central role of health technicians in epidemiological surveillance, diagnosis and assistance, the COVID health emergency demanded immediate and consistent responses from governments and educational institutions, favoring the strengthening of the health technician epistemic community through the circulation of discourses and the hegemonization of meanings for the education of technicians. These actions, however, do not translate into stability or homogeneity for the epistemic community, since their articulation is always provisional and contingent, nor do they ensure the capacity to directly influence policies in each country.

RESUMEN En este artículo se examina el desempeño de la comunidad epistémica vinculada a la educación de técnicos en salud a partir del análisis de las medidas iniciadas por el centro colaborador de la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS) para la educación de técnicos en salud durante la pandemia de COVID-19, con el objetivo de comparar estas medidas con los principales elementos que definen la constitución y el funcionamiento de las comunidades epistémicas, de conformidad con la bibliografía especializada. Se argumenta que, a pesar de las diferencias en la configuración histórica de los sistemas nacionales de salud y de educación, el surgimiento de desafíos comunes para la educación de técnicos propició la articulación de demandas, el intercambio de evaluaciones con fines de diagnóstico y la cooperación entre la Red Internacional de Educación de Técnicos en Salud, la Red Iberoamericana de Educación de Técnicos en Salud y la Red de Escuelas Técnicas de Salud de la Comunidad de Países de Lengua Portuguesa, con el fin de promover el intercambio de experiencias, la búsqueda de soluciones estratégicas y la difusión de recomendaciones entre los países. Al reafirmar el papel central de los técnicos en las medidas de vigilancia epidemiológica, diagnóstico y atención, la emergencia de salud exigió respuestas inmediatas y coherentes de los gobiernos y de las instituciones educativas, lo cual favoreció el fortalecimiento de la comunidad epistémica vinculada a la educación de técnicos en salud al hacer circular discursos y ejercer hegemonía con respecto al sentido de la educación de esos profesionales. Sin embargo, esta actuación no confiere estabilidad ni homogeneidad a dicha comunidad epistémica, en vista de que sus afirmaciones son provisionales y contingentes, ni asegura su capacidad de influir directamente en las políticas de cada país.

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This work is mainly aimed at the detection, visualization and description of the scientific collaboration patterns in the Nursing field in Latin America as a response to the lack of evidence on the implications of collaboration and its effects on the scientific influence in the Nursing field. For this purpose, a retrospective quantitative analysis was conducted by including all the publications classified under the code 2900 in All Science Journal Classification Codes of Scopus, corresponding to the field of General Nursing during 2005-2020. A total of 40 countries and 362,354 unique publications were analyzed, although the main subset herein consists of 18,371 unique publications authored by Latin-American institutions. World proportion of Latin-American publications in Nursing is higher than all the publications in the region. This increase is especially remarkable in the latest year of the studied period, which may result from the progressive increase in the numbers of nursing schools, the diversity in the graduate and specialization programs, the creation of scientific societies, and the many conferences carried out recently on Nursing.

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The current knowledge society has driven an unprecedented mobility of people, especially scientists, from emerging economies to developed countries. This mobility can allow the development of human talent and the access to first class infrastructure and resources, but it can also mean a loss for emerging economies due to the phenomenon of brain drain. To counteract this situation, some countries in Latin America and the Caribbean have developed models for the articulation of their scientific diaspora in projects and programs, with the aim of exchanging knowledge and capitalizing on human and technical resources to advance science, technology and innovation systems. Likewise, science diplomacy has become a tool for interlinking the work of various actors in order to advance the solution of national, transnational or global problems through scientific advice. Scientific diasporas are vital in new structures of cooperation, enabling them to innovate and solve problems jointly, advising their countries of origin and articulating policies and programs. This research seeks to analyze the interactions and initiatives identified between the organized scientific diaspora from Latin America and the Caribbean and their countries of origin in relation to science diplomacy processes, providing recommendations and proposals for public policy to improve the interaction between the diaspora and the governments of their countries of origin. Results show that diaspora organizations from Latin America and the Caribbean engage with governmental and non-state actors and are active science diplomacy stakeholders promoting the scientific developments of their country or their researchers, as well as enabling access to research resources creating alliances for scientific, institutional and academic collaborations. In the cases studied, these efforts are planned and executed by the diaspora without responding to any science diplomacy strategy of the country. Policies and programs are needed to effectively link the scientific diaspora organizations to the interests of the countries.

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Resumo A partir do papel central da saúde mental para a saúde global e a complexidade da universalização de políticas de cuidado, este artigo discute aspectos da saúde mental global por meio de uma pesquisa situada entre dois países, Brasil e Itália, potenciais referências para o intercâmbio entre Norte e Sul global. Trata-se de pesquisa-ação colaborativa, sob perspectiva etnográfica, realizada por meio de uma comunidade virtual de prática composta por brasileiros e italianos interessados no cuidado comunitário em saúde mental. Os resultados são apresentados em cenas que fornecem pistas para o debate internacional em pelo menos três aspectos: a lógica do cuidado médico-centrado, a institucionalização do cuidado e a medicalização do sofrimento, e a contribuição das práticas comunitárias e dos saberes locais e não especializados. As cenas localmente situadas dão relevo a nós, críticos, globalmente compartilhados, explicitando um conjunto plural de relações que atravessam o processo de trabalho e cuidado em saúde mental. O compartilhamento de experiências e conhecimentos aponta para o que deve ser universalizado: as oportunidades de intercâmbio horizontal ao invés da produção de identidades nacionais irradiadoras de práticas e políticas universalizantes.

Abstract Recognizing the central role of mental health in global health and affirming the complexity of the universalization of care policy, this paper discusses aspects of global mental health in Brazil and Italy - two countries that are a potential reference for exchange between the global North and South. Using ethnographic and action research methodologies, we conducted a study of a virtual community of practice composed of Brazilians and Italians interested in community mental health care. The results are presented in scenes that provide insights for the international debate in three categories: the doctor-centered approach to care; the institutionalization of care and medicalization of suffering; and the contribution of community practices and non-specialized local knowledge. The locally situated scenes cast light on globally shared critical knots, elucidating a plural set of relationships that run through work processes and mental health care. The sharing of knowledge and experiences highlight what should be universalized: opportunities for horizontal exchange, rather than the production of national identities that radiate universalizing practices and policies.

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Introducción: La atención primaria de salud en Brasil se considera una prioridad. En el año 2013 se creó el Programa Mais Médicos, de formación en servicio y de ampliación de la cantidad de médicos en el país. La cooperación cubana, gestionada por la Organización Panamericana de la Salud fue quien envió la mayor cantidad de profesionales. Objetivo: Analizar las representaciones sociales de los consejeros de salud sobre el Programa Mais Médicos, en municipios en los que prestaron atención a su población médicos provenientes de Cuba. Métodos: Estudio de caso descriptivo de corte transversal abordado con metodología cualitativa. La muestra fue intencional. Se trabajó con 58 entrevistas semiestructuradas y el análisis fue realizado mediante el software gratuito Iramuteq con la técnica de análisis lexical. Resultados: Se pudo distinguir cuatro grupos de representaciones, sobre el funcionamiento de los consejos municipales de salud, sobre las representaciones del Programa Mais Médicos, sobre las redes de atención y sobre los médicos brasileños y cubanos. El estudio aporta evidencias de la aplicación de un nuevo modelo de atención para los consejeros que objetivaron y anclaron en el concepto de nacionalidad. El modelo cubano incorpora características de humanismo, atributos que no estaban contenidos en las representaciones sobre los médicos locales. Conclusiones: Las representaciones sociales sobre el Programa Mais Médicos aluden a una acción que mejora la calidad de los servicios, no obstante, la literatura sobre atención básica aún deja ver algunos problemas de acceso y tránsito por la red del sistema único de salud(AU)

Introduction: Primary health care in Brazil is considered a priority. In 2013, Mais Médicos Program was created, providing in-service training and expanding the number of doctors in the country. Cuban cooperation, managed by the Pan American Health Organization, sent the largest number of professionals. Objective: Analyze the social representations of health counselors on Mais Médicos Program, in municipalities in which doctors from Cuba cared to their population. Methods: Descriptive cross-sectional case study approached with qualitative methodology. The sample was intentional. It was conducted a work with 58 semi-structured interviews and the analysis was carried out using the free software Iramuteq with the lexical analysis technique. Results: Four groups of representations could be distinguished: on the functioning of the municipal health councils, on the representations of Mais Médicos Program, on the care networks and on Brazilian and Cuban doctors. The study brings evidence of the application of a new model of care for counselors who objectified and anchored in the concept of nationality. The Cuban model incorporates characteristics of humanism, attributes that were not contained in the representations about local doctors. Conclusions: The social representations on Mais Médicos Program allude to an action that improves the quality of services, however, the literature on basic care still shows some problems of access and transit through the network of the health system(AU)

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Introducción: La solidaridad médica cubana llega a Timor-Leste cuando no habían transcurrido dos años de su independencia, con una infraestructura de salud muy dañada y prácticamente sin médicos disponibles para garantizar los servicios básicos de salud. Objetivo: Analizar el aporte de la solidaridad médica cubana en la mejora del estado de salud de la población de Timor-Leste en el periodo 2004-2019. Métodos: Se realizó una investigación cualitativa, que se apoyó en el estudio descriptivo y retrospectivo y se aplicó el método etnográfico. El periodo de estudio abarcó 15 años, desde 2004 hasta 2019. Conclusiones: La solidaridad médica cubana en la salud de Timor-Leste, durante estos 15 años, ha contribuido a modificar el cuadro sanitario que tenía ese país cuando logró su independencia en el año 2002, convirtiéndose en uno de los países con mejores indicadores en la Región de Oceanía. La asistencia médica y la formación de estudiantes en Cuba y en el propio Timor-Leste son elementos decisivos de la cooperación de Cuba en la trasformación y fortalecimiento del sistema sanitario timorense, factores esenciales para alcanzar la cobertura universal de salud(AU)

Introduction: Cuban medical solidarity arrives in Timor-Leste two years after its independence, with a badly damaged health infrastructure and practically no doctors available to guarantee basic health services. Objective: Analyze the contribution of Cuban medical solidarity in improving the health status of Timor-Leste´s population in the period 2004-2019. Methods: A qualitative research was carried out, which was based on the descriptive and retrospective study and the ethnographic method was applied. The study period spanned 15 years, from 2004 to 2019. Conclusions: Cuban medical solidarity in Timor-Leste, during these 15 years, has contributed to modify the health picture that the country had when it achieved its independence in 2002, becoming one of the countries with the best indicators in the Oceania Region. Medical assistance and the training of students in Cuba and in Timor-Leste itself are decisive elements of Cuba's cooperation in the transformation and strengthening of the Timorese health system, which are essential factors in achieving universal health coverage(AU)

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Introducción: Los enfoques políticos, sociales y económicos desde los cuales se canaliza la cooperación internacional en salud influyen en el desarrollo de los sistemas sanitarios. Su adecuada utilización potencia los logros obtenidos como complemento a los esfuerzos gubernamentales para mejorar la salud de la población. Objetivo: Analizar la evolución de la cooperación internacional en salud en Cuba en el periodo de 1960 hasta 2018 y su vínculo con el desarrollo del Sistema Nacional de Salud desde una perspectiva social. Métodos: Se realizó una investigación cualitativa documental, sobre la base del método histórico-lógico. El periodo de estudio estuvo comprendido entre 1960, fecha de creación del Sistema Nacional de Salud, y 2018. Desde una perspectiva social, se aborda el vínculo desde lo teórico, entre la evolución de la cooperación internacional en salud con el desarrollo del Sistema Nacional de Salud cubano. Conclusiones: Las capacidades de recursos humanos y científico-técnicas de Cuba junto al desarrollo del sistema de salud constituyen una fortaleza que permite un adecuado uso de los recursos que se reciben por la cooperación internacional, con un marcado enfoque social y en beneficio de la salud de la población(AU)

Introduction: The political, social and economic approaches, from which international cooperation in health is channeled, influence the development of health systems. Its proper use enhances the achievements as a complement to government efforts to improve the population health. Objective: To analyze the evolution of international cooperation in health in Cuba 1960 to 2018 and the link with the development of the National Health System from a social perspective. Methods: A qualitative documentary research was carried out, based on the historical-logical method. The study period was from 1960, when the National Health System was created, to 2018. From a social perspective, the theoretical relation between the evolution of international cooperation in health and the development of the Cuban National Health System is addressed. Conclusions: The capacities of human and scientific-technical resources of Cuba, together with the development of the health system, constitute a strength that allows adequate use of the resources received by international cooperation, with marked social approach and for the benefit of health of the population(AU)

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