The project did not take hold until the United States' foreign policy priorities turned to other regions in the s. The resolution of the conflict via UNASUR underlined the authority and efficacy of the still-nascent organization and represented an important diplomatic achievement.
Although Brazil also extended its muscle across to Africa and in selected multilateral for such as the WHO, the World Intellectual Property Organization, and the World Trade Organization, as Riggirozzi b shows health also became a strategic policy driver redefining the terms of regionalism in South America.
In this context, some commitments over a range of social policy areas were made but low levels of institutionalization for implementation, coordination, and compliance affected the depth and pace of regional social policies. Soon after, both Gran Colombia and the United Provinces of Central America fell apart and the whole of Hispanic America was balkanized by competing national governments.
The difference between those early XIX century efforts and the XXI century ones is that the former grew out of apprehension and led to coordinated surveillance. Absent such a step, the organization may come to be viewed more as protecting incumbents than working to strengthen democratic institutions or hold leaders accountable.
Global health governance solidified and diversified after World War II and new concepts and concerns appeared with the establishment of the WHO Fidler, According to this line of thought, South American integration, which has a shaky history at best, may ultimately drain time and resources that Brazil could better spend on either domestic issues or increasing its international influence on a broader scale.
Sanitarism and social medicine especially in Brazil continued to work to develop a linked approach to social epidemiology and to assert the ambitious goal of collective health and social determinants of health to address the causes of ill health: poverty and inequalities Solar and Irwin, ; Whitehead et al.
The right to health, universal access, and social determinants became overtly political flags.
Beyond that central emphasis for horizontal cooperation, the South American Health Council has a high profile instrumental role in global diplomacy developing common positions in the WHO. Health was conceived as a right and institutionalized Tobar, Very quickly it acquired a central role, though naturally not at all an uncontested one, in regional governance.