South America and State intervention to confront Covid-19
Planned and directed public policies on health seem to be decisive for populations, as shown by day-to-day experience in South American countries. The market does not have the ability to prevent and heal on its own.
BUENOS AIRES, ARGENTINA — The French doctor Silvie Briand is the director of the World Infectious Risks Preparation Department of the World Health Organization (WHO) and is concerned about the situation of poor countries, badly called developing countries, in the midst of the Covid-19 pandemic.
Their concern, actually, is that of the WHO. In a web interview with student journalists from the University of Texas Knight Center on how to cover the Coronavirus pandemic, Briand revealed that one of the WHO’s concerns is the health systems of developing countries. On the one hand, because according to the projections of the international medical organization, 20 per cent of the world population will suffer the effects of Covid-19 with serious illnesses that will require sophisticated medications. This situation will be amplified in poor countries, on the one hand with high mortality rates among its population and a strong impact on medical personnel.
In developed countries 10 per cent of medical personnel will be affected by Covid-19, says Briand. And he wonders, how much can that figure rise in developing countries? In some developing countries there is one doctor for every ten thousand inhabitants and therefore the impact of the disease on these doctors multiplies its negative effects on the population, increasing the rates of disease and death.
South America is getting hit by Covid-19 after its initial rapid spread in Asia, Europe and the United States.
Official reactions to the pandemic were different and dissimilar in the different countries of South America. And it could be said that the reactions respond to the political colour of each of the governments. Those neoliberals decided to launch the state health apparatus later than governments with the interventionist or popular bias. The explanation? Do not alter the market.
Argentina
A few days after the Argentine government decreed preventive and compulsory social isolation, on March 20, it not only received praise from the World Health Organization (WHO), but was also chosen by the international health organization as one of the ten countries where the first coronavirus vaccine will be tested. Spain, Bahrain, France, Thailand, Canada, Iran, Norway, South Africa, Switzerland and Argentina will be the first ten countries to try a treatment for the Coronavirus cure.
The government of President Alberto Fernández took office last December 10 with an external debt of more than 100 billion dollars and the aggressive claims of external creditors and the IMF for collecting it. With just two months in office, Fernández saw the pandemic across the Atlantic Ocean towards America. On March 20, he established by decree the social confinement that every two weeks reviews on TV for the entire population to see where it can be relaxed. Total closure of educational establishments, classes taught remotely via the internet, outlets to buy food only in neighbourhood shops and use of compulsive face masks throughout the country. From the State, subsidies were paid to self-employed workers and economic measures were taken in support of all sectors with the issuance of currency above the reserves.
In health matters, the most important measure was to re-establish the Ministry of Health eliminated by the previous Liberal government. The country invests 9.4 per cent of its GDP in health, according to figures from the Pan American Health Organization (PAHO) for 2019.
Chile
It allocates 8.9 per cent of GDP to Health, which represents $ 2,182 per capita, but today it borders on the one hundred thousand cases of Covid-19 and 1,054 killed with a health system on the verge of collapse. The dilemma of “the last bed” in hospitals shows the crisis of the health system in all its harshness.
Businessman Sebastián Piñera began his second presidency on March 11, 2018. Although his right-wing party takes turns in power with a centre-left coalition alternating presidential terms, the womb of the Chilean economy is inherited from the military dictatorship of General Augusto Pinochet who ruled the country for 17 years between 1973 and 1990 and imposed the Margaret Thatcher-style market economy stamp. Education is private and health too, with a system similar to that of the United States in the pre-Barack Obama stage when health insurance appeared.
The outbreak of the pandemic was a respite for Piñera who had to endure almost daily since last January the street protests demanding a constitutional reform to modify the privatized education and health systems.
Uruguay
With three consecutive progressive governments headed by the Frente Amplio, a left-wing coalition that brings together 16 political parties, the country allocated until March 1, when Luis Lacalle, a right-wing businessman, assumed 9.5 per cent of its product Gross Domestic (PBI) to the Public Health area. The first and third of the periods of government were chaired by the medical oncologist Tabaré Vázquez.
The country has 823 cases of coronavirus and 11 cases of death.
Brazil
It has a public health system that covers 75 per cent of social needs free of charge and 25 per cent by disbursement (payment). This was established by the Constitution passed in 1988. However, President Jair Bolsonaro’s scant interest in taking the pandemic seriously led to Brazil being the country that had the first case of Coronavirus in South America on February 26 and the figures shot up so that by June 1 it would be the most infected in the region and the fifth with the most deaths in the world, behind the United States, Great Britain and Italy. It has 279,096 infected cases and 29,341 deaths. The world press shows a president beside himself whenever he talks about the pandemic. Angry at the media and unconcerned with the virus.
Paraguay
Despite a doubling in the health budget, annual investment per capita reaches $ 461, a third of that invested by other neighbouring countries such as Uruguay, Brazil or Chile. The data is curious if one takes into account that in relative terms the government’s investment is high. It spends 9.8 per cent of its GDP in Public Health.
With 986 contagion cases and 11 deaths, it is one of the countries that has best supported the pandemic.
Bolivia
After toppling the Evo Morales government after three periods of government, the transitional government is on its way to becoming a dictatorship. The reforms tested by Morales in access to health earned him the recognition of the WHO in February 2019 for the management of his government, the possibility of accessing preventive and highly complex medicine for the lowest social strata throughout the country, through the Universal Health System. It reached 7.7 per cent of its GDP invested in health in 2017.
The 9,982 confirmed cases of coronavirus with 313 deaths show how the fabric of the health system generated in the past government resists and allows the current authorities to contain a pandemic that could be greater.
Peru
It was the first country in South America to impose a strict quarantine. However, at the close of this note, it ranks as the second Latin American country with the most infections — behind Brazil — with over 155,000 affected and 4,371 deceased.
In 2019 the country allocated 3 per cent of its GDP to the Health area, despite the fact that the World Health Organization considers that 6 per cent should be considered an optimal level of investment in each country.
Explanations must be sought according to health experts in the country in the collapse of the health system resulting from successive governments with erratic policies in that area. The country has had liberal governments for the last twenty years, with the exception of a brief interregnum between 2011 and 2016 when Ollanta Humala, a former military officer leaning on a conglomerate of progressive parties that brought him to power, assumed power, although during his administration he did not generally depart from liberal postulates to guide state action. According to the public management expert, sociologist Gabriela Del Castillo, the country has not modified the health structure from the State and has not invested in public health in the last twenty years.
WHO data indicates that the country invests just over 3 per cent of GDP in Health but has 70 per cent of workers not registered by the state, only 38 per cent of families in cities have a refrigerator and that figure drops to 15 per cent in rural areas. Inequality works as a catalyst to expand Covid-19.
Ecuador
The images that travelled the world with corpses piled on the streets or preserved in precarious conditions in the popular houses of the city of Guayaquil, seem a clear example of the overflow of the pandemic situation in the country.
Ecuador has as president Lenin Moreno, an initial heir to the ex-centre-left president Rafael Correa who in a few months made the leap towards right-wing policies. In 2019 the Public Health budget represented 2.78 per cent of GDP. Last March the Minister of Health, Catalina Andramuño resigned due to lack of resources to face the Coronavirus.
With more than 5,000 deaths and latent social demand, on May 19, President Lenin Moreno announced a cut in public spending of 4 billion dollars, especially in salaries for medical personnel, to face the payment of the foreign debt, curiously, due to the consequences of the pandemic caused by Covid-19. But a week later he announced in his speech to the National Assembly a supplement of $ 760 million for the Health area.
Colombia
The country allocated 7.2 per cent of its GDP in 2019 to the Health area, which represents $ 960 per capita per year, according to OECD data.
President Iván Duque declared compulsory social isolation in the country on March 22 and extended it every three weeks until next July 1. At the close of this note, the country had 939 deaths and 29,383 infected.
Venezuela
Under the government of Nicolás Maduro, the State allocates 0.8 per cent of GDP to health, according to a data crossing by private consultants, ECLAC and PAHO. According to the WHO, in 2015 it invested 5.8 per cent of its national budget in health but that dropped to 1.6 in 2016 and at the end of 2019 it was cut in half. However, the figures are eloquent of the situation: 1,510 cases and 14 deaths. Curious for a country in the sights of the United States and its foreign policy.
The brief review shows that the pandemic whose peak seems to reach the region is best resisted by countries whose health systems have not only resources but also new state intervention in terms of priorities. The infatuation of the market shows in crisis situations that absolute economic freedom does not solve the problems of citizens and their quality of life.
