Union of South American Nations in Mitad del Mundo, Ecuador, where the cornerstone was laid for the headquarters of the General Secretariat of the Union. In April 2018, six countries suspended membership: Argentina, Brazil, Chile, Colombia, Paraguay and Peru. In August 2018, Colombia announced its withdrawal from the organization. At the Third South American Summit on 8 December 2004, presidents or representatives from 12 South American nations signed the "Cusco Declaration", a two-page statement of intent announcing the foundation of the South American Community. Panama and Mexico attended the signing ceremony as observers in Brazil. The mechanics of the new entity came out of the
Union of South American Nations its bodies and managing the Technical Secretary. The Pro Tempore President has a two-year term that may be extended for another two years, being unconditionally succeeded by a president from a different country. The SHC is supported by the Technical Secretary in charge of the Pro Tempore Presidency (PTP) and two countries of the previous and following PTP, in order to ensure the continuity of works. It is technically supported by the South American Institute for Government in Health (ISAGS). Additionally, it is composed of five Technical Groups 1- Health Surveillance and Response; 2- Development of Universal Health Systems; 3-