Chronic diseases and the unavoidable transformation of health systems in Latin America

The rising burden of chronic non-communicable diseases constitutes a significant challenge for health care systems worldwide, especially for developing countries. Notwithstanding, the majority of health systems provide inadequate chronic care. Discussing the vertical approach of several global health efforts aiming at improving chronic care and looking at the evidence provided by the Cuban health system and other European and Latin American countries, I suggest a Primary Health Care strategy as a very integral and feasible solution for improving the management of chronic conditions. I propose to go beyond the health systems strengthening agenda and to launch an international agenda for health systems transformation. This switching movement should consists of at least three elements: epistemological, operational and ethical transformations.