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IJMF 2020,4(1);1-5 | https://doi.org/10.26855/ijmf.20200001
University of Medical Sciences, Santiago from Cuba, Cuba
In the universal covering of health he/she stands out the importance of the financing in the systems of health and of the population's resources to consent to the sanitary services, where they also influence other aspects, as the lack of political will, of knowledge, organization and preparation of the authorities and the directive of the different sectors and levels, to achieve an attention that belongs together with the social determinant of the health. Although they are defined the exogenous problems that affect to the population's health and that they influence in the systems of health, as the environment, the natural disasters, among others; he/she is not necessary how these systems owe interaction in a more active way with the phenomena that originate them and the factors that intervene, for what you/they are carried out some proposals to such effects in this article.
The World Organization of the Health (OMS), through their regional offices, for a lot of time he/she has come developing a meritorious work in pro of the health like social right for all the people.
It is worthwhile to highlight, like references, the different scenarios where so important topic has been approached, as the "he/she Confers International of Primary Attention of Health" with its motto "Health for all in the year 2000", the Commission of Macroeconomics and Health, the "he/she Confers World cup on Decisive Social of the Health", the "Strategy for the Universal Access to the Health and the Universal Covering of Health”. [1-4]
In each one of them it was present the economy, with emphasis in the financing, like indissolubly bound part to all process of the society, and it also stood out how the promotion and the protection of the health are essential for the human well-being and for a sustained human development.
In this respect, the OMS has proposed suitable methods to adapt the mission of the sector from the health to the new prevailing economic and social contexts in each country and in the international environment, what could get rich with additional economic procedures.
Although in the Universal Covering of Health the exogenous factors are pointed out that influence in the state of the population's health, it is not appreciated or he/she is not necessary how to achieve that necessary interaction between the systems of health of each nation and this elements, among them, the environment and the natural disasters, for their impact about the population health and, consequently, in the services of health. 
So much the documents on the essential functions of the health and the objectives of development of the millennium up to the 2015, as the new calendar of the objectives of sustainable development up to 2030, contemplate specific aspects about the health, but also those related with the social determinant of the state of the population's health, in order to propitiate a space for the insert more integrated in these on the part of the national systems of health. [6-8]
The employment of the academy, as generating of formation and suppuration of the human capital, the investigations and the evaluations, it should be explicit part of the strategy. Also, the local development, the participation aware of the authorities, the formal and informal leaders and the community, with an appropriate preparation, it becomes indispensable in this whole process.
Taking like base the previous arguments, in this article some complementary elements are described that they could be kept in mind so that the purposes of the universal covering of health in their integrate achieve the effectiveness, efficiency and sustainable in the systems of health.
The Dr. Ortún Rubio  summarizes in its concentric ring of a system of health, the steps of "the what a one, the how and the one with what", as unpardonable components for the process, from the level big - until the small -. In the big administration it places the politicians of health, of regulations and of financing; elements of the logic that are not always organized in that way in some countries, what can cause improvisations with importance damages for the systems of health.
In the meso administration they are reflected the entities and the insurance of health--publics and private--that offer the different sanitary services, which should be to harmonize with the purpose of facilitating bigger coverings to the population.
On the other hand, in the small administration he/she stands out the professional practice that represents to the human capital, the one which with their preparation and performance can contribute notably to the effectiveness and wanted efficiency.
In the information of the Commission of the Macroeconomics and Health,  after valuing the problems of the countries according to each region, recommendations and courts later evaluative are exposed; this it is a valuable instrument that is in the center of the identification and action.
The essential functions of the public health are based so much in processes and movements that allow a better acting of their administration, regarding the internal factors as to the external ones. The strategic importance of these functions, as the surveillance and promotion of the health, resides in the generation on the part of the system of sanity, of an effective, efficient answer and of quality, as regards health, to interest’s collective. 
On the efficiency and the to support of the public systems of health, the OMS has identified several aspects that influence negatively, and he/she has offered some proposals that they can impact in a positive way in the achievement of the objectives of this program, to knowledge: 
Or the costs of the sanitary attention continue growing due to the increment of the chronic illnesses, the aged population and the new and more expensive treatments, together to the economic recessions.
Or the urgency of having financing systems to achieve, also, the fair balance among the population with medical covering and the offer of the services with efficiency and equality.
Or the existence of points where he/she is reflected a wrong expense among 20% and 40% of the resources dedicated to the health, what indicates the search of options to improve the efficiency, and that the results are in correspondence with the investments. On this important aspect they are reflected the ten main causes of the lack of efficiency, like a guide to work in solutions and alternative possible.
Or the valuations related with the financing, as the interventions at low cost with high impact--still without exploding--, the nets of social protection, the mutual ones of sure, the public-private medical insurance, the percentages of the gross internal product dedicated to the health, which should not be less than 6%, with priority in the promotion and the primary attention; the use of medications generic essentials; the obligatory medical insurance; the taxes on noxious products; the appropriate use of the international cooperation; among others.
Or the most integral proposal, as fundamental aspect, is to go eliminating the direct payments for the prepaid, with the creation of an unique joint bottom, which offers the biggest advantages, as the crossed grants in the population and the obtaining of efficiency, what will influence in the decrease and/or elimination of the fragmentation.
The to be justice, and necessity to have considered to the poorest, the natives, the emigrants, the rural areas, the informal sector, as well as the pocket expenses.
Other identified problems that are related with the shortage of human resources, as for their formation and retention conditioned by the work conditions and the appropriate payment, what influences in the yield, the quality and the impact of the results.
The recognition of the importance of the language of the economists, the harmonic relationship that should exist among the ministries of economy, finances and health, as well as the aspects related with the management, the supervision, the control and the audits, to improve the organizational processes.
The necessity that each country makes an analysis of its weak and strong points, for, with the necessary adaptations, to carry out a process of progressive adaptation that also allows supporting in the time.
It is important to consider other complementary and also necessary elements that you/they can go consolidating the strength of the national systems of health in the acting of their important mission; these they are the following ones:
In the Universal Covering of Health  the objectives are enlarged with a group of actions, mainly toward the interior of the systems of health. Nevertheless, if the processes inside the system of health are vital, they are also important the external processes that, in a way or other, they are related and/or they respond to this system.
Among the determinant of the state of the population's health they figure:
The World Conference on the Social Determinant of the Health, made in River of Janeiro, Brazil, in the 2011, put in evidence the social inequalities, defined by political and economic forces, in vital aspects as the education, the employment, the gender justness, the health, the civic right and the protection to groups hurt. 
Perez Martinez,  in their article Agustín has more than enough Lage, he refers that this investigator left established that for the survival and the quality of the non alone patients' life should be considered the treatment, but also other social elements, as the feeding, the lifestyles, the environmental environments and the education, among other, where the combination of a biological determinant with other social, economic and/or cultural, they are supplemented in the achievement of a full health. This has also been an important position in international investigations.
In a same way, in the Conference Integrated Latin American University and the Population's Health, taken place in Cuenca, Ecuador,  was left explicit that the university should possess a linking to the productive work, with a design curricular chord with the strategies of change, where the teaching is articulated with the services and the investigation.
According to the report of the results of the program "Objectives of Development of the Millennium 2015", and in spite of recognizing that all could not be reached, besides the limitations of the sources of data, it doesn't fit the smallest doubt that a significant advance has existed in most of its purpose.  In this many aspects related with the social determinant of the health and its consequent affectation converged to the state of population health. On the other hand, in the objectives of sustainable development for the 2030, those are evidenced that keep a narrow relationship with that noble purpose.
In spite of the international economic context and of the problems that present or they could present the countries, the strategy of the universal covering and their financing, it will advance progressively and with more sustainable possibility, when being integrated in an active way in the different scenarios that promote a social, cultural, educational, sure and healthy environment.
Casulo J. C. The Integral Strategy of Health: A Necessary Focus. Int J Med Front. 2020;4(1);1-5; https://doi.org/10.26855/ijmf.20200001