Resumen
This work is based on a view of healthcare as a fundamental Sustainable Development Goal (SDG) to share globally to be effective at local level. On this basis, the paper analyzes the health programs in less-favored areas with the aim of understanding why the United Nations SDGs are so difficult to reach in some countries. A brief review of the main literature and research on the health governance systems in three countries of the African continent have been conducted to this aim. The results are interpreted through the sustainability helix model (SHM). Key roles and conditions of effectiveness of the health sustainable development governance approach in the investigated countries are discussed. The main findings reveal that the analyzed governance systems lack implementation plans. By discussing the observed problem in the light of the sustainability helix model, fundamental elements of a health sustainable development helix model have been identified in less favored countries where key actors and roles are identified. The study highlights, in particular, the relevance of ‘interface’ roles played by non-governmental actors (NGA) and international actors (IA) in the health governance system of less-favored countries. These actors and roles allow connections between the global and the local levels of action favoring interaction among actors institutionally devoted to governing development.