La crisis sanitaria mundial relacionada con la Covid-19 (sars-Cov-2) ha generado tensión en el conjunto de los sistemas políticos del planeta, desestabilizó los sistemas económicos y sociales y supuso un desafío para las organizaciones internacionales y regionales. A pesar de que en América Central los Estados miembros del Sistema de Integración Centroamericano (Sica) y, en el Caribe, los Estados miembros de la Caricom se caracterizan por su fragilidad, las dos regiones presentan un desempeño sorprendente en lo relativo a la gestión de la crisis sanitaria. Ponemos a prueba hipótesis relativas al aprendizaje institucional, a la ayuda exterior y a la distribución espacial, para explicar esta contradicción aparente de la resistencia ante la crisis sanitaria, a pesar de la debilidad de las estructuras regionales del Estado.

What explains the variation in how states collectively deal with public health challenges across different regions? We tackle this puzzle by comparing the regional health governance efforts pursued within the Central American Integration System (SICA) and the Union of South American Nations (UNASUR). We show that Central America's health governance has been driven by external actors, whereas South America's was driven by states within the region, and remained insulated from external actors’ influence. We argue that the explanation for such variation lies in the interplay of state capacity and regional leadership. In Central America, weak state capacity combined with the absence of a regional leader willing to provide governance resources. This opened up space for external actors to contribute actively to regional health governance, complementing the governance of Central American governments. In South America, Brazil's regional leadership mobilised neighbouring states’ capacities by promoting a South-South cooperation agenda based on intra-regional exchanges among national health bureaucracies, which, however, proved vulnerable to intergovernmental conflicts. Through the comparison of Central and South America, the article bridges the gap between global health governance scholarship and comparative regionalism, providing new insights on the determinants and effects of regional health governance modes in the Global South.

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Le Panama est un petit pays d’Amérique centrale, surtout connu pour son canal et, depuis l’affaire des Panama Papers , son système d’évasion fiscale. Cet État a longtemps vécu sous la tutelle des États-Unis et cherche depuis les années 1990 à affirmer son indépendance et sa souveraineté. Pour ce faire, il mise notamment sur son intégration, non seulement dans les circuits économiques et financiers internationaux, mais aussi dans les grandes instances multilatérales.

Various United Nations organizations and representatives have released declarations about the deterioration of the Venezuelan and Nicaraguan situations since 2017. The United Nations Security Council, the General‐Secretary, and the Office of the High Commissioner for Human Rights have been particularly active on these issues. The positions of the selected institutions and their representatives were diverse, and sometimes contradictory, and the polarized contexts in which such declarations have been made emphasized diversity. Based on a sociological approach of international organizations, this article demonstrates that the United Nations as an actor is not a coherent and unique entity. To understand the difficulties the organization faces in dealing with the Venezuelan and Nicaraguan crises, it seems indispensable to go beyond the traditional dichotomy between states and institutions, and power politics. Indeed, institutions are plural—the United Nations through states is conservative and cautious, whereas the United Nations through the individuals and staff is more assertive and critical of the Venezuelan and Nicaraguan governments.