The Emerging BRICS *(Brazil, Russia, India, China, South Africa) economies became the engine of real GDP growth worldwide a decade after the end of Cold War Era - in late 1990s and early 2000s. Since March 2023 their joint output has exceeded the one of G7 even in nominal terms while in purchase power parity terms BRICS account for more than a half of world economic output.

These countries are crucial determinants of global health spending and financing landscape. BRICS are the major drivers fostering supply and demand for medical goods, services and pharmaceuticals covering unmet needs of almost 86% of mankind population beyond wealthy OECD countries.

UN Agenda 2030 and its Sustainable Development Goals (SDGs) are anticipated to combat the widespread poverty across 150+ of LMICs countries situated in the Global South. Innovation of technology in biomedicine, pharmaceutical and medical device manufacturing, is gradually shifting away from its traditional hotbed in North America and Western Europe towards South-East Asia, ASEAN and wider Western Pacific region.

All these profound changes are substantially affecting sustainability of healthcare financing and provision in BRICS+ countries and other comparable nations across the Global South. Third demographic transition of Silver Tsunami of population aging is accelerating and raising further constraints on shrinking labor markets. It means that tax base of contributions to the retirement and pension funds is also dwindling.

Current health financing models were all created in the era of demographic growth and juvenile populations of early XX century and post-WWII (Cold War Era) decades. This system ceased to be efficient long ago and many needs of the elderly citizens remain underserved. This is particularly worsened by gradual extinction of family caregiving model in many Asian countries due to low, below-replacement fertility levels. The only partial exemption from this rule among large nations is India who remains still in far more juvenile stage of population aging. India is about to harvest a demographic dividend and labor market expansion of up to 150 million young educated work force until 2050.

Yet huge regional disparities among wealthy, coastal, industrialized regions and rural, agricultural ones is still huge while Gini index shows ever growing socioeconomic gaps between rich and the poor citizens in all of BRICS+ nations. Among other phenomena these circumstances have led to substantial rise of out-of-pocket health care expenditure and spread of catastrophic household spending.

These and many other changes are rapidly evolving and shaping the landscape of medical care financing and provision in preventive, hospital and outpatient facilities across wide regions of the Global South.

With this GHES Special Issue we invite and welcome submissions referring to the BRICS+ or other Low-and-Middle-Income countries (LMICs) of the Global South broadly tackling any of these phenomena.