The Global South—Economic History and Health Systems Development
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Researchers |
Mihajlo Jakovljevic, Akihiko Ozaki, Munjae Lee, Tetsuya Tanimoto, Tiago Correia, João Paulo Teixeira, Ronny Westerman, Arcadio Cerda, Narimasa Kumagai, Chhabi Ranabhat, Michael Talias, Takashi Miyachi, Resham Khatri, Romanus Osabohien, Jay Pan, Pragyan Monalisa Sahoo, Hao Hu, María José Muñoz Torrecillas, Morteza Arab-Zozani, Yudai Kaneda, Javad Javan-Noughabi, Hui Jin, Himanshu Sekhar Rout, Leidy Garcia, Erika Yamashita, Charles Ezenduka, Ajantha Sisira Kumara, Eugene Kouassi, Saeed Shahabi, Wenqing Wu, Chiranjivi Adhikari, Makoto Kosaka, Merhawi Gebremedhin Tekle, Sulaiman Mouselli, Tran Khanh Toan, Salvador Cruz Rambaud, Obinna Ikechukwu Ekwunife, Tissa Wijeratne, Vijay Kumar Chattu and Lizheng Shi |
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Published in |
Global South & Sustainable Development, volume 1, issue 1, January 2026. |
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Abstract |
The low-and-middle-income-countries (LMICs) of the Global South witness rapid health system development with substantial heterogeneity of affordability of medical care. Financial sustainability challenge is hard to understand without knowledge of economic history. Centuries have witnessed Colonialization, slave trade, world wars, Cold War, Non-Aligned Movement and Colonial Liberation Movements. Painful legacy shaped contemporary economic growth, and ability to invest in healthcare. There is expanding demand for health workforce-to-population ratio and supply of essential pharmaceuticals and medical devices. Despite rapid expansion of the middle class throughout the Global South, out-of-pocket spending remains excessive, while catastrophic healthcare expenditure is widespread. Most of the newly established welfare and abundance of disposable resources for healthcare investment are centered among the BRICS countries (Brazil, Russia, India, China, and South Africa). Despite significant health expenditure growth in PPP terms, LMICs’ insufficiently prioritize medicine in budgetary spending. Global South inability to meet ever-rising demand for medical care will remain constrained by wide socioeconomic inequalities and vulnerability of the poor. Sustained economic growth requires strategic interventions that prioritize equitable healthcare access and financial toxicity protection. Without comprehensive reforms that account for historical legacies and resource constraints, the promise of universal health coverage in the Global South will remain elusive. Key words: global south; Third World; LMICs; Developing countries; healthcare; sustainability; cost; economics; history; Geopolitics; health financing; BRICS; belt and road; emerging markets; medicine; health economics; health policy. |
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Link to full paper |
