This paper examines how the Union of South American Nations (Unasur) concerned itself with ensuring democracy and participation in the construction of health policies. It aims to explain the meaning of health democracy, and its importance for making the right to health effective. The concern is that the decision on these politics of the bloc should be in harmony with the interests of their citizens, so as to identify ethical activity of the States in international relations. An analysis was made of the documents of constitution, and resolutions on health policy, of this bloc, and statements were found with objectives and principles about democracy and citizen participation; but no institutionalization of mechanisms that might make participative democracy in health operational was found.