The global onset of the coronavirus and the attendant need for health-related responses have exposed the debilitating limitations of the health services in Latin America and the Caribbean countries, says a recent report prepared by the Economic Commission for Latin America (ECLAC).
While most countries in the region have, over the years, managed to attract only periodic serious outside attention to their national health deficiencies, the ECLAC report, which deals with health services as part of a wider summary of how COVID-19 is impacting Latin America and the Caribbean (“Latin America and the Caribbean and the COVID-19 Pandemic: Economic and social effects:” April 2020) asserts that the underdevelopment of the health sector in most countries in Latin America and the Caribbean has been the result of “underinvestment in health,” a circumstance that has resulted in “shortages of skilled labour and medical supplies” and “escalating costs.”
The ECLAC assessment notes that central government spending on the [health] sector, which in 2018 stood at 2.2% of regional GDP, was far from the 6% of GDP recommended by PAHO. “Most countries in Latin America and the Caribbean have weak and fragmented health systems, which do not guarantee the universal access needed to address the COVID-19 health crisis,” the assessment observes. The ECLAC assessment discloses that “health systems [in Latin America and the Caribbean] are organised through public sector services for people with low incomes, social security services for formal workers, and private services for those who can afford them. As a result, health systems remain segregated and patently unequal, providing different services of varying quality to different population groups.” Beyond this, the assessment notes that health systems in Latin America and the Caribbean tend to be geographically centralised, with specialised services and physicians concentrated in a few urban centres, which are “insufficient for the level of expected demand, and heavily dependent on imports of equipment and inputs,” which, in itself, is a major problem since with the onset of COVID-19, as of March 11, twenty four countries around the world have restricted exports of medical equipment, medicines or their ingredients.
According to the ECLAC assessment, even before the onset of COVID-19, the health systems in several countries in Latin America and the Caribbean had already been placed under pressure by dengue fever which had recorded more than 3 million cases in the hemisphere in 2019.
Meanwhile, ECLAC’s report says that the population in the hemisphere covered by private insurance “could face high co-payments for access to coronavirus tests which would be an obstacle to early detection,” while it cautions that the health systems of countries with a population distribution more skewed towards older adults (it names Barbados, Cuba, Uruguay, Aruba and Chile) could be put under greater pressure.
Meanwhile, noting that several CARICOM countries – including Trinidad and Tobago, Jamaica and St. Lucia – had “suspended classes at all levels of education,” the report says that “disruption of activities in educational establishments will have a significant impact on learning, especially for the most vulnerable. It says that while the onset of COVID-19 had triggered efforts to promote the use of digital devices in educational systems, these had had only limited effect since many educational establishments do not have the necessary digital technology infrastructure. “In addition, there are gaps in access to computers and the Internet among households. Distance learning and teaching processes are not guaranteed. Moreover, there are disparities in access to digital devices and broadband Internet between urban and rural populations.” Indeed, efforts to roll out virtual classrooms here in Guyana have been undermined by many of these limitations.
The report also expresses concern over the likely impact of school closures on the disruption of schools feeding programmes in the hemisphere, noting that suspending classes will have “an impact beyond education, affecting nutrition, care, and parents’ [especially women’s] participation in the labour market.” Children living and attending schools in some of the hinterland regions of Guyana and who are the beneficiaries of school meals are among those in the hemisphere who cannot now access those meals.
