International public health: between old and new paradigms.

today's changing world, public health has had to adjust to new demands arising out of the intense activity of complex and dynamic cultural, social, and economic processes that transcend borders. The dizzying development of trade, modes of transport, and telecommunications, which has led to the nearly exponential growth of migration, has contributed to this phenomenon. Changes in the health status of populations have revealed that the old ways of thinking are incapable of explaining and dealing with health and have led to the creation of new paradigms. Thus, today it is accepted with little discussion that the public health of a country is not a strictly national issue that can be fully controlled with the domestic measures adopted by local government. The borders between countries have become highly permeable to market phenomena that bring resources and opportunities with them, as well as risks and diseases. The complexity of the political and social processes experienced by the international community since the last century has generated a wealth of experiences that concretely represent the interaction of the countries on health issues, often inspired by opposing paradigms that reflect, in turn, the different interests of the stakeholders participating in the negotiations. The concepts of " international health, " " health cooperation, " " global health, " " global fund, " and " market for health commodities, " as well as others, have been integrated into the political agenda as new paradigms. This process, including its conceptualization and the practices that aim to consolidate it, are still in full development. An example of this can be found in the articles that the Revista Panamericana de Salud Pública/Pan American Journal of Public Health (RPSP/PAJPH) has included in this special issue. The publication of these articles, which describe experiences aimed at promoting greater interaction between countries to improve the health of the population, is intended to encourage discussion on the scope and limitations of international health vis-à-vis the current situation of the countries of the Region. The activities have not always met with the same success or been carried out in the same way, and the causes of their limitations can be linked to their conceptual and ideological foundations. This is the matter considered by Birn in her article Remaking international health: refreshing perspectives from Latin America. The achievements and the limitations encountered throughout the more than 100 years of work of the Pan American Health …