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HEALTH SYSTEMS
IN
SOUTH AMERICA
therefore be the ones that build up new possibilities in the training of health professionals and those that protect direct democracy and participation of the population in the formulation of policies, in the control and monitoring of health services quality; that is to say, that democratization of society and social participation in institutional spaces of the health system are essential. But it is worth pointing out that when social participation is institutionalized as is now happening in the Health Councils (national, state and municipal) of Brazil the capacity to be critical, innovative and bold is partially lost. This is practically inevitable: the State apparatus is penetrated and autonomy is lost. We actually have to rethink how to organize large democratic spaces to renew health systems, which will also have a greater capacity for self-innovation the farther away they turn from disease and the closer they approach health, the more they dialogue with other sciences, other knowledge and policies. Working with other sectors and cross-sectioning are essential categories to be able to approach health from a broader and more integrated perspective. How can we think about health today without thinking about education, scientific and technological development or without thinking about other social and economic policies that directly and indirectly have an impact on health? The greater the openness of the Ministries in charge of health to this debate with other areas and other dimensions, the stronger their innovation capacity will be. The seventh transition could be called economic, scientific and of innovation. Lately, in Brazil, we have been building something new in the way we think about the relationship between health and development. We have to understand that health has an intrinsic dualism that differs from any other public policy: it is, at the same time, a fundamental policy to improve living conditions but it is also an economic and extremely important dimension that generates jobs, development and innovation. The available international estimates presented at the Global Forum for Health Research in 2006 indicate that health accounts for 20% of the world’s public and private expenditure where research and technological development account for an updated 135 billion dollars, clearly one of the most dynamic areas of research and development in the world. Health, therefore, has two dimensions that jointly offer new opportunities for the development of our countries. Health is part of the social policy and of the system of social protection and, at the same time, a source of wealth creation. The right to health articulates with a highly dynamic set of economic activities that can virtuously relate to a standard of development seeking economic growth and equality as complementary objectives.