This past May, we held our Second Annual Global Health Conference, once again hosted by Spain’s Royal National Academy of Medicine (RANME) in Madrid. This year’s gathering brought together leading voices in international public health to grapple with one of today’s defining challenges: how to move toward the elimination of diseases in a global landscape that has been profoundly reshaped.
In her opening remarks, Dr. Silvia Gold, President of Mundo Sano, reminded the audience that the global order we once knew has been weakened. The pandemic laid bare just how fragile health systems can be, and the funding cuts and political shifts that followed have eroded cooperation programs and cast doubt on multilateral governance. Against this backdrop, she argued, talking about disease elimination has become more complicated—but also more necessary than ever.
In the face of that uncertainty, Dr. Gold made the case for the strategy that defines Mundo Sano: generating the evidence that shapes public health policy. She stressed that eliminating a disease is never a standalone technical achievement; it demands integration, public policies that endure over time and, above all, equity.
Chagas as a starting point
The event’s central panel, moderated by Dr. Pedro Alonso—Chair of Mundo Sano’s Advisory Board and former Director of the WHO Global Malaria Programme—took Chagas disease as both an example and a springboard for tackling the many challenges facing public health interventions: integrating services, reaching vulnerable communities, and interrupting mother-to-child transmission.
Dr. Roberto Chuit, who coordinates the Foundation’s Chagas program, opened the presentations by pointing out that Chagas is no longer a disease confined to Latin America—it has become a global problem. Today, more than 9 million people worldwide carry the parasite, with cases in Europe, the United States, Asia and Oceania, and over 70,000 in Spain alone. He explained how the epidemiology has shifted—mother-to-child transmission is now the leading source of new cases—and drew a clear conclusion: the tools already exist. What’s missing is the health system’s ability to get them to the people who need them, and to do so in time.
Dr. Antonieta Rojas de Arias brought that idea down to earth with the experience of the SAFEStart+ project in Paraguay, which tackles the mother-to-child transmission of HIV, hepatitis B, syphilis and Chagas all at once. Her message was blunt: “The challenge today is no longer a biological one—it’s a structural one.” Elimination, she noted, depends less on technology—that problem has been solved—and more on whether health systems can stay with every mother and every child without losing them along the way, weaving services together through the windows of opportunity that already exist, such as prenatal visits to address vertical transmission.
From local to global: integration and country ownership
Dr. Daniel Ngamije, Director of the WHO Global Programme on Malaria and Neglected Tropical Diseases and former Minister of Health of Rwanda, broadened the conversation to look at how health systems can integrate their strategies and at the importance of country ownership. He shared how Rwanda brought different programs together under a single leadership and managed its relationships with donors through one unit, and he made the case for strengthening countries’ own capacity to design their strategies and run their own programs—rather than simply repeating the patterns of the past.
Dr. Jarbas Barbosa, Director of the Pan American Health Organization (PAHO), highlighted the Americas’ long-standing leadership in eliminating multiple diseases and in developing homegrown regional tools such as the revolving vaccine fund. He set out three lines of work: embedding disease elimination within primary care, ensuring resilient medicine supply chains and access to health technologies, and working from within communities, where the barriers are not only economic but social and cultural as well. Eliminating diseases for which we already have the tools, he added, is also a moral and ethical obligation.
Keeping people at the center
The closing remarks came from Dr. Marina Gold, Director of the Mundo Sano Foundation, who reflected on the thread running through the day and underscored one central idea: keeping people at the center. Because when we talk about people, she noted, we shouldn’t only be thinking of patients and vulnerable communities—health systems are made up of people too, each with their own constraints and struggles. “Health systems are relationships between people,” she said, calling for a holistic approach that sees each person in all their complexity.
With this second gathering, Mundo Sano reaffirms its commitment to sustaining a space for rigorous, engaged dialogue—one that helps inform decisions, build consensus, and keep bringing better health to where it’s needed most.
